Showing 1 - 10 of 2886 Literature annotations

Hair

Corso, Gregory

Last Updated: Apr-25-2021
Annotated by:
Mahl, Evan

Primary Category: Literature / Poetry

Genre: Poetry

Summary:

The poem, through an account of the narrator’s experiences with losing hair, explores issues such as aging, sexuality, and our impotence when faced with the vagaries of nature as it transforms our bodies. Ranging from ancient Egyptian lore to dime store pharmacies, Corso weaves a kaleidoscope of images about how humans treat and worry about their hair and how hair has been a mythopoetic vehicle for millennia.Much of the poem employs angry though humorous language whereby the narrator speaks to his hair and pleads with the gods to reverse his fate. Corso writes, "To lie in bed and be hairless is a blunder only God could allow--"; and later, "Damned be hair! . . . Hair that costs a dollar fifty to be murdered!" The poem ends with an angry diatribe against hair and an inspired denigration of its mythological power.

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Parenthesis

Durand, Élodie

Last Updated: Apr-23-2021
Annotated by:
Miksanek, Tony

Primary Category: Literature / Nonfiction

Genre: Graphic Memoir

Summary:

Judith, a French woman in her early twenties, experiences "spells" - episodes of shaking, staring, and sudden memory loss. These spells occur daily and her behavior becomes erratic. She visits a neurologist. He diagnoses epileptic seizures and prescribes medication. Yet the convulsions continue so Judith's drug dose is upped and an MRI of the brain is done.

The MRI scan finds a small tumor that appears inoperable. A brain biopsy reveals an astrocytoma. Judith's life now revolves around her illness and the medical monitoring of it. Time feels distorted, and she likens her seizures to "a little death." Everyday life becomes blurred. She is advised to see a neuropsychiatrist. Her parents worry about her constantly.

Eventually Judith is referred for Gamma Knife radiosurgery. Eighteen months after the procedure is completed, only a tiny scar at the site of the tumor remains. Three years following the treatment, the seizures are gone. She rediscovers the joy of life and embraces a hopeful future.

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Summary:

Mindy Thompson Fullilove, MD, is a Black social psychiatrist with wide-ranging interests; her book analyzes factors that support or diminish the health of cities as places that sustain its citizens. Over many years, she has visited and studied 178 cities in 14 countries, and she draws on the work of experts from several disciplines to address the fundamental question: how may we best live together?  

Her discussion moves through five concepts for understanding the health of a city by describing a dozen cities ranging from Paris to Jersey City. Each features a “Scroll,” a two-page presentation of photos, graphics, and text. Her discussions give an inductive basis for her concepts that become criteria for assessing the health of any city.     

(1) Box (“in all sizes and shapes”): the surrounding shape of buildings, street, and sky; it gives an identity to the city’s center with its useful assets such as stores, post office, bank, food, and entertainment.
(2) Circle: the larger area surrounding a Box—maybe a half a mile in radius. Its health requires ease of travel to and from the box.
(3) Line: usually the Main Street that runs through the box, therefore a central path to town. Good transportation is important, and the main street can be quite long, for example Palisades Avenue in Englewood, New Jersey.
(4) Tangle: a dense network of streets and highways that connect to main streets and the Box.
(5) Time: no city is static; as years go by, there are changes for good or ill.  

Fullilove mentions politics, capitalism, poverty, disincentives, tribalism, racism, highways, malls, interstates, and “urban renewal” that destroyed neighborhoods of minorities, as well as redlining against Blacks and gerrymandering school districts to segregate Black and white students. 

In “Naming and Framing the Problem,” she turns to a larger overview of challenges for cities in many places, but especially in the US:
(1) “deep structure of inequality” (p. 211), such as the legacies of slavery, lynching, the 3/5 Compromise, and the Trail of Tears, as well as white supremacy today (2) ecological damage, including industrial farming, deforestation, and global warming, and (3) the inertia of the status quo. 

Citing Dr. Martin Luther King, Jr., and Father Richard Rohr, Fullilove affirms love as the root  for social justice, political activism (p. 211) so that cities might become what Thomas Edison termed “factories of invention” that will support the mental health and well-being of all of its citizens. 
 

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Motherless Brooklyn

Lethem, Jonathan

Last Updated: Apr-12-2021
Annotated by:
Teagarden, J. Russell

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Lionel Essrog is the narrator and main character of the novel, although when his Tourette syndrome kicks in, he might introduce himself as: “Liable Guesscog, Final Escrow, Ironic Pissclam, and so on” (p. 7). Tourette syndrome is a neurological condition causing involuntary, repetitive movements and vocal sounds (e.g., words, utterances, growls)—tics. 

Lionel lived at the Saint Vincent Orphanage in Brooklyn, New York until a local “penny-ante hood,” Frank Minna, recruited him and three other “white boys” to do his bidding as a “motley gang of high-school-dropout orphans.” (p. 291) Truck piracy was their first line of work, all the while oblivious about why they were moving boxes from one truck to another. Minna expanded his business into more lucrative and dangerous activities under the façade of a limousine service and private detective agency. He gets too close to the sun and is murdered. Lionel liked Minna, who became a father figure to him, accepted his Tourette quirkiness, and even conspired with him to throw their clients off balance when it served their purpose. Though Lionel admitted, “We were as much errand boys as detectives,” he recasts himself as a bona fide detective and makes finding the murderers his raison d’être. (p. 156) 

In typical murder-mystery fashion, Lionel must wend his way through complex relationships and find hidden clues to solve the case. In not-so-typical fashion, he contends with the Tourette syndrome accompanying him; Tourette is a major character in the book. Together, they find who murdered Frank Minna. 

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Annotated by:
Zander, Devon

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

Fevers, Feuds, and Diamonds is Paul Farmer’s latest work exploring the connection between health and the social and historical structures that surround it.  Focusing on how and why Ebola spread in West Africa in 2014, the book is difficult to categorize — it is not only temporally expansive, ranging from the late 15th century to the present day, but it also combines elements of a memoir, an anthropological treatise, and an abbreviated historical text with powerful calls to action in over 500 pages.   

Stemming partially from a desire to fulfill a “personal penance for inaction” during the early days of the outbreak, Farmer chooses to learn about Ebola from “the personal histories of the Ebola dead, of survivors, and of their caregivers.”  Harking back to his days as a college anthropology major, many of the book’s themes, embodied in its title, are introduced via these in-depth interviews.  His two main subjects, Ibrahim and Yabom, are Ebola survivors who, after initially recovering from their illness, make it their work to support other Ebola survivors.  Through their words and narratives, we witness some of what it was like to experience the civil strife that predated the outbreak, see how Ebola expanded from isolated cases to clusters and communities, how family members sick with the disease were cared for, what it meant to survive Ebola, and now what it means to live with its sequelae.  Translation for Farmer was provided by Dr. Bailor Barrie, one of his former students, whose story as a medical student in Sierra Leone during its civil war soon becomes part of the narrative, as well.  Through the words of these three people, pieced together over many extensive conversations, a narrative is developed, allowing those most impacted by Ebola to tell its story. 

Farmer interweaves his first-person perspective with their stories, emphasizing his role in 2014 and how Partners in Health became involved in assisting in the outbreak.  While working in West Africa during the Ebola epidemic, late one night, Farmer mixes up Liberia and Sierra Leone.  Realizing how different their histories are, he vows to “make amends for my ignorance” and transitions from storytelling on the personal level to history-telling on the country level.  To ensure that he, and we, never mix them up again, Farmer traces the histories of Sierra Leone, Liberia, and Guinea in four chapters.  During this section, he refers back to the book’s title, taking on the effects of the rise of imperialism, colonization, the use of sanitation/Pasteurian principles, the impact of resource extraction, and much more on each of these nation’s stories and relationships with Ebola.  As he describes it, “if you want to understand the magnitude and dynamics of this Ebola epidemic, in other words, think in terms of fevers, feuds, and diamonds.” 

Fevers, Feuds, and Diamonds is bookended with reflections on COVID-19 in the introduction and epilogue.  In the introduction, he reflects on the book’s “obvious implications for our response to COVID-19” and how COVID-19, though different in many ways, shares certain similarities with Ebola — among them, the speculative nature of its origins and the fact that it is a zoonosis.  Most importantly, according to Farmer, treating and managing it will require understanding many of the same “cultural complexities and... challenges” that treating Ebola required.  After taking us on a journey through West Africa and up to 2014, Farmer writes an epilogue reflecting on how the central crisis of Ebola was the prioritization of “containment over care” whereas COVID-19 has become a crisis of containment.  To him, writing this on April 10th, 2020, and to the reader reading it a year later, COVID-19 is seen as partially a disease of healthcare workers’ exposure, and partially a disease of social inequity, but completely a disease whose management, treatment, and eventual control will be defined by the “staff and stuff and spaces and systems” in place and who has access to them.  Even with this pandemic at the forefront of our minds, Farmer reminds us that Ebola should not be off our radar just because a new disease is on it— there continue to be outbreaks of Ebola in the Congo.  Ultimately, Farmer’s words leave you thinking — about this pandemic, about the past, and about the connections between them.  If only to prompt more thought, one of Farmer’s last comments is also his most powerful: “If there’s indeed a lesson to be learned from Ebola, it may be this one:  for everything we do, or say, in pandemic time, let’s keep asking the same question.  Might this help?







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Camouflage

Nisker, Jeffrey

Last Updated: Mar-19-2021
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Plays

Genre: Play

Summary:

This short play has three characters: a woman, a man in camouflage, and a second man who turns out to be a doctor. The camouflage man talks on the phone with his unseen wife; he is angry and suspicious of what she has been doing during his absence. The doctor overhears – and thinks about confronting him, but lets it go. The woman is a victim of coercive sex in marriage. She has two places where she can take refuge, if only in her mind:  her garden and an imaginary elephant. The woman’s description of the elephant tells us that she is seeing the elephant as a reflection of herself, and it also reflects her traumatized awareness of the physical changes in her husband’s body as he helps himself to hers.

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Summary:

In this collection of autobiographical essays, Koven contemplates some unique challenges confronting female physicians: discrimination, sexism, lower annual salary on average than male counterparts, possible pregnancy and motherhood. She recalls her medical school and residency experience, describes her internal medicine practice, and highlights her role as a daughter, spouse, and mother.

Worry is a theme that works its way into many phases of Koven's life and chapters of this book. The opening one, "Letter to a Young Female Physician," introduces self-doubt and concerns of inadequacy regarding her clinical competence. "Imposter syndrome" is the term she assigns to this fear of fraudulence (that she is pretending to be a genuine, qualified doctor). She worries about her elderly parents, her children, patients, and herself. Over time, she learns to cope with the insecurity that plagues both her professional and personal life.

Some of these essays are especially emotional. "We Have a Body" dwells on the difficult subject of dying, spotlighting a 27-year-old woman who is 27 weeks pregnant and diagnosed with adenocarcinoma of the lung. "Mom at Bedside, Appears Calm" chronicles the author's terror when her young son experiences grand mal seizures and undergoes multiple brain surgeries for the tumor causing them.

Listening emerges as the most important part of a doctor's job. Koven encourages all doctors to utilize their "own personal armamentarium" which might include gentleness, exemplary communication skills, a light sense of humor, or unwavering patience. She fully endorses a concept articulated by another physician-writer, Gavin Francis: "Medicine is an alliance of science and kindness" (p228).

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Summary:

Doctor’s Choice is a collection of 16 stories by authors from and well known in the early-to-mid 20th century. I offer four summaries of the stories that I am considering using in teaching.

“Rab and His Friends” by John Brown, MD, was originally published in 1859 and is sometimes referred to as young adult literature. It was one of Brown’s most successful works. The story is told in the voice of a medical student, “John”, and begins with his reminiscence of six years earlier when he first met the old “huge mastiff” Rab, and his “master”, a carrier named James Noble. John, who had befriended Rab during medical school, next sees him ‘one fine October day’ as he was leaving the hospital. Rab was with James who was bringing his wife, Ailie, to see a doctor because “she’s got a trouble in her breest…” (p.37). Examination showed no doubt that the tumor needed to be removed. Having survived the breast amputation (without anesthesia and observed by the narrator and his fellow students), four days later Ailie’s delirium set in. With James by her side, and with tender caring, Ailie died a few days later. Soon after James took to bed “and soon died…The grave was not difficult to reopen. A fresh fall of snow had again made things white and smooth; Rab once more looked on, and slunk home to the stable” (p.46). The next week John sought out the new carrier who took over James’s business to ask about Rab. The new carrier tried to brush him off—but admitted he killed the dog, explaining that the dog was inconsolable and that he had to “brain him wi’ a rack-pin….I could do naething else”(p.46). John thought it a fitting end… “His teeth and his friends gone, why should he keep the peace and be civil?”

“Miracle of the Fifteen Murderers” by Ben Hecht, was originally published in Collier’s Magazine in 1943. The narrator of this story passes along a tale he heard from an elderly friend, a physician who was one of 15 eminent physicians that formed a secret group meeting quarterly to discuss the ‘medical murders’ they had committed. The group had been meeting for the past 20 years, but had disbanded due to the outbreak of WWII—“The world, engaged in re-examining its manners and soul, had closed the door on minor adventure” (p.139). The last meeting of the group is the subject of the tale and it describes how the newest member, a young surgeon, tricked the group into providing the diagnosis for a patient this doctor, Samuel Warner, was struggling to care for. Warner explained that his patient—who he had befriended--, a young Negro boy of “seventeen, was an amazingly talented [poet whose work] “was a cry against injustice. Every kind of injustice. Bitter and burning,” (p.149). After working hard for 2 weeks to save his life, and realizing that his diagnosis of ulcerative colitis was wrong, Warner’s scheme (a feigned medical murder) got the eminent physicians to the diagnosis: a fishbone had caused the perforation that was threatening the poet’s life. Grabbing his hat and coat—and after thanking the doctors for the diagnosis- Warner is off to save his patient’s life. A half-hour later, rising to the call as well, the other 14 doctors joined Warner in the operating room to view the life-saving procedure, allowing one of the eminent physicians to remark with a soft cackle, that “the removal of this small object….will enable the patient to continue writing poetry denouncing the greeds and horrors of our world” (p. 154). 

There was no original publication date for “The White Cottage” by L.A.G. Strong, but it has been anthologized since at least 1940. The narrator tells of a visit by a locum town-based doctor to an island nearby to help a woman give birth at her home. The perilous journey from the town to the island with the expectant father and a neighbor as navigators and rowers ends with all thoroughly drenched from a storm after nearly capsizing. Realizing that the doctor has no dry clothes to change into, the couple offers him the husband’s flannel nightgown and a blanket. The doctor, after checking the wife and estimating a number of hours of labor ahead, goes to the living room by the fire. Fearing he’s still chilled, the couple decides to make room in their bed for him. After hesitating for a moment, he climbs in next to the husband. After some small talk and an ‘order’ for the soon-to-be mother to lay on her side and have her husband rub her back, the doctor begins to assess the situation he finds himself in: “Right living was not obedience to rule: it was a balance, renewed each instant, like a tight-rope walker’s, a tension between opposites. Here, for a moment, in this bed, in this cottage, in this tiny focus of life, beneath storm and towering sky, was wisdom. Men did not possess wisdom. It possessed them. Like a light, it flickered here and there over the vast dark mass of humanity, illuminating briefly every now and then a single understanding. Here, for the moment, it possessed him; and by its light he gave thanks, and loved all men” (p. 249). After a successful delivery (and some celebratory drink and breakfast), the doctor was off to his town with a promise to return for a checkup. His new friend demurred. “No trouble man. It’s a pleasure—besides being my plain duty. Mind you, she’ll be right as rain. But I’ll come” (p.252), responded the doctor. After a silent handshake, and suddenly finding “eyes full of tears … he clambered into the boat” (p. 252).

“Doc Mellhorn and the Pearly Gates” by Stephen Vincent Benet was originally published in 1929. The story begins with an in-depth description of a humble, impish (having mastered many diversionary tricks), and independent small town doctor and the place he practices, but quickly moves to much larger realms through Benet’s use of magical realism. Doc Mellhorn has died but has not fully landed in his final destination, heaven, and decides to spend a bit of time in hell first because of the perceived lack of opportunity to practice medicine in heaven (and an off-putting encounter with an overly officious clerk at the pearly gates). When he gets to hell, he gets to work on setting up a clinic—“mostly sprains, fractures, bruises and dislocations, of course, with occasional burns and scalds… [reminding him] a good deal of his practice in Steeltown, especially when it came to foreign bodies in the eye” (p.23). After a number of months, and a confrontation with another officious bureaucrat, Doc got back on the road to his original destination, giving him some time to think about whether he was deserving of that final abode. “I’m a doctor. I can’t work miracles,” he thought. “Then the black fit came over him and he remembered all the times he’d been wrong and the people he couldn’t do anything for” (p.28).  Landing for a second time at the pearly gates, he finds family waiting for him with assurances that there’s more than just eternal peace in heaven. “They wouldn’t all arrive in first-class shape," (p.31) explains his Uncle Frank, assuring him that there will be lots of work for him to do. Uncle Frank also lets him know that a delegation is coming to meet him since Doc had “broken pretty near every regulation except fire laws, and refused the Gate first crack” (p. 32). Then, out of a phalanx of famous doctors (from a list that Doc began to create during his first, shortened visit), appeared—with “winged staff entwined with two fangless serpents”-- his top choice--- Aesculapius. “The bearded figure stopped in front of Doc Mellhorn. Welcome brother, said Aesculapius. It’s an honor to meet you, Doctor, said Doc Mellhorn. He shook the outstretched hand. Then he took a silver half dollar from the mouth of the left-hand snake” (p.32). ….I laughed out loud—and couldn’t imagine a better ending.




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The Doctors Blackwell begins with an account of an auspicious new beginning—the opening of The New York Infirmary for Indigent Women and Children, the first women’s hospital staffed by female physicians. Founded in 1857 in New York City by Drs. Elizabeth and Emily Blackwell with the express purpose of providing clinical experience to female physicians, the hospital was a landmark achievement in the long struggle for parity in medical training. The Doctors Blackwell goes on to trace the history of the institution and of its two founders, themselves trailblazing members of the medical profession as the first and third women to earn medical degrees in the United States.

Two of nine children born to abolitionist, Protestant dissenters in Bristol England, Elizabeth and Emily Blackwell were the recipients of a strict moral upbringing. While successful in instilling the values of education and hard work, their childhood also left them socially awkward and with the sense that they were both morally and intellectually superior to those outside of their family. When the Blackwells emigrated to New York City in 1832 and then on to Cincinnati in 1838, their social circles were confined to religious and abolitionist advocacy. Yet soon after the family arrived in Cincinnati their lives were upended by the passing of their father, Samuel Blackwell. With their mother and six siblings to support, the three eldest Blackwell daughters-- Anna, Marian, and Elizabeth-- took up teaching until their younger brothers were old enough to support the family.               

Elizabeth, morally principled to a fault, studious, and determined to succeed intellectually, found teaching to be an unfulfilling means of channeling her energies. Having forsworn marriage at the age of 17, she longed for something challenging and admirable upon which to focus her formidable intelligence. When a dying friend suggested that she become a physician, because she herself would have appreciated a female doctor tending to her disease, Elizabeth’s interest was piqued. Yet her attraction to medicine was rooted not in a desire to help the ailing (indeed she viewed illness as a form of weakness), but in an ideological quest to prove that women were capable of achieving the same distinctions as any man. She saw herself as a moral crusader with the goal of uplifting all of womankind.              

Beginning in 1844, Elizabeth leveraged her teaching connections to gain the backing of several prominent male physicians. Yet the all-male world of medicine remained stubbornly closed to her, and it wasn’t until 1847 that she was admitted to the Geneva Medical College in upstate New York, an event that caused a stir in the medical community and beyond. Isolated both from her male classmates and from laypeople, who viewed her at best as an oddity and at worst as a dangerous anomaly,  Elizabeth nonetheless became a figure equally admired and reviled by the public.  Her reputation as the first “lady doctor” preceded her, even as she gained the respect and admiration of the faculty at Geneva College and distinguished herself with additional training in Europe.                    
 
Meanwhile, the trials of Emily Blackwell, whom Elizabeth encouraged to follow in her footsteps, illustrated that far from breaking down the doors that barred women from medicine, Elizabeth’s admittance may only have served to seal them more tightly. Elizabeth was viewed as a notable exception to the general rule that women were unfit to practice medicine, and her male colleagues were uneasy at the thought of being replaced. But after a prolonged struggle, Emily succeeded in obtaining her medical degree from Cleveland Medical College and joined Elizabeth to hang up her shingle in New York City.              
Increasingly frustrated by the difficulty in recruiting private patients to be seen by female physicians and by the dearth of clinical opportunities for the growing number of women in the field, Elizabeth and Emily opened their own hospital and medical school with the help of female philanthropists. Elizabeth’s philosophical zeal combined with Emily’s true love and aptitude for medicine proved to be a dynamic combination. Their contributions to the field not only changed the way that medicine is practiced, but also paved the way for generations of female physicians. Today, just over fifty percent of the nation’s medical students can trace their acceptance into the profession to the dogged determination of these two extraordinary women.   









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Annotated by:
Miksanek, Tony

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

Pearl, a plastic surgeon and former CEO of a large medical group, writes powerfully and poignantly about the major role of physician culture - the customs and rituals, traits and beliefs of doctors. This culture is entrenched through years of medical training. He decides that physician culture "can be both a virtuous force and an equally destructive influence" (p70).

Some of that culture is readily on display: attire, tools of the trade, unique medical terminology, insensitive humor, frequent handwashing. Positive aspects of physician culture include self-confidence, integrity, compassion, and selflessness. Negative elements are ingrained to keep emotions and dread at bay: detachment, callousness, denial. This culture of medicine must navigate dual interests - healing (the mission of medicine) and profit (income, status, prestige).

Pearl suggests an evolutionary pathway for physician culture that he dubs "the five C's of Cultural Change" - confront, commit, connect, collaborate, contribute. He tackles issues of sexism, racism, and elitism in American healthcare. He explores the suffering of physicians and their need to seek forgiveness - often secretly and even in cases of perceived "failure" when everything possible was done correctly. His discussion is filled with agonizing, frustrating, and loving stories about patients, family members, and colleagues (including physician suicide).

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