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The Empathy Exams

Jamison, Leslie

Last Updated: Aug-02-2021
Annotated by:
Zander, Devon

Primary Category: Literature / Nonfiction

Genre: Collection (Essays)

Summary:

Leslie Jamison starts The Empathy Exams with a quote from The Self-Tormentor by Terence, first in Latin, then in English: “I am human: nothing human is alien to me.”  In beginning this way, she sets up the book to explore the human condition and what it means to relate to one another with caring despite the interpersonal complications that can often arise. Through a series of nonfiction essays (some initially published elsewhere) she explores how we express our feelings and process those of others. To do this, Jamison uses a number of different lenses, large and small, including ultramarathons, immigration, incarceration, a Morgellons disease conference, and more.  

The book takes its name from the first essay in which Jamison juxtaposes her experience as a standardized patient for students in medical school with being an actual patient. She specifically explores the ways in which empathy is created/manufactured and extended in medicine, both from medical professionals and loved ones.

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The Ministry of Bodies

O'Mahony, Seamus

Last Updated: Jul-26-2021
Annotated by:
Miksanek, Tony

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Starting eight months before his retirement, a gastroenterologist chronicles a myriad of encounters between himself and others - patients and their family members, colleagues, administrators, hospital staff, and even drug reps. He has worked for many years at a large Irish hospital dubbed the "ministry." His professional work there is divided between the endoscopy unit (where he performs colonoscopies and EGDs), medical wards, an outpatient clinic, and the ER.

Given his specialty, the roster of patients tilts heavily towards gastrointestinal problems: alcoholic cirrhosis, GI bleeding, chronic diarrhea, and abdominal pain. But additionally, his days are filled with patients presenting with a variety of medical problems including pneumonia, mental health issues, heart failure, serious fractures, dementia, seizures, anemia, and cancer. He attends to many frail elderly folks in the emergency department. His interactions with patients range from intense to jovial, from unexpected to heart-wrenching. For example, a woman with chronic abdominal pain asks the doctor if she might be suffering from PTSD. When asked why she thinks that might be possible, her reply is "My son hung himself. I found him" (p191).

The doctor is beleaguered by frequent, and at times wacky, emails generated by the hospital bureaucracy as well as unproductive meetings. He must cope with his own health problems too (a vitreous detachment, arthritic hands, and unexplained nosebleeds). He decries the "foolishness" of excessive medical testing and overtreatment and cites the case of a young woman with irritable bowel syndrome who already had over 1,200 test results logged in the hospital lab. He describes the ministry as "an oasis of kindness and comfort" but "also a place of chaos and conflict, of institutional cruelty" (p8).

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Summary:

Richard M. Ratzan brings together scholars and creative writers to celebrate the legacy of the sixteenth-century Flemish physician and anatomist, Andreas Vesalius (1514–1564), and his 1543 landmark text, De Humani Corporis Fabrica (On the Fabric of the Human Body). Ratzan defines the volume as an “ekphrastic collection of poetry, art and short prose” inspired by “the inimitably conceived and executed anatomical woodcuts” of Vesalius’s most enduring creation (xi). Organized by different genres, Ratzan presents introductory essays, ekphrastic works, translations of Vesalius-inspired poems, and detailed note and bibliography sections. The collection does not merely panegyrize but articulates the deeper intellectual import of De Humani’s meticulous anatomical renderings. Sachiko Kusukawa’s introductory essay frames De Humani as a “rhetorically charged polemic and defense” that challenged the European medical institution in two key ways (3). First, it promoted the revival of the “ancient [Greek and Roman] practice of healing based on diet, medicines and surgery,” a bold effort that aimed to resuscitate anatomy and other forms of “hands-on engagement” that had fallen out of favor with Vesalius’s contemporaries (2). Second, De Humani emendated the anatomical descriptions advanced by Galen, a second-century physician who promoted dissection in his Anatomical Procedures and whom European physicians considered an authority (3). This volume captures the fascinating fusion of artistry and intellectual individuality that characterizes Vesalius’s work.

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Summary:

Native Ohioan Brian Alexander cares a lot about his state and its many economic problems, especially as they impact healthcare. For this book, he’s an on-the-ground reporter covering the events in and around a hospital in the small town of Bryan from 2018 to 2020. He is also an in-depth interpreter, analyzing the many dilemmas of this small hospital and emphasizing that these represent parallel problems of social justice for all of contemporary American healthcare.  An opening chapter reviews some of the difficult history of this area, including economic collapse, lack of public health, lack of health insurance, and collapse of jobs in supply chains for Detroit.           

While the timeline of the story is short, it has wide breadth in local and national issues. These are illustrated by the stories  of specific people. Marc Tingle, a local contractor has a heart attack; his wife falls ill and is diagnosed with cancer. Medical bills mount up. Marc has a second heart attack and a stent inserted. He, like many others receives “rescue” medicine, not preventive healthcare, due to social or economic issues beyond their control. Similarly, we read about Keith Swihart, overweight and diabetic. He has a foot ulcer that requires surgery and later partial amputation. He has eye problems that progress to near blindness. Valerie Moreno injures her back at work but does not report it to the company, considering herself tough, but she must have spine surgery. After being laid off, she has part-time jobs, money problems, and turns to OxyContin pills. These are dramatic and painful stories.  

Many families make “just enough money to disqualify themselves…from Medicaid, but not enough to afford coverage offered by an employer or via the Affordable Care Act” (p. 242).            

Such patients illustrate a deadly whirlpool of issues: lack of routine medical care, inadequate health insurance, no national health program, a collapsed economy with no good jobs or prospects of advancement, poor nutrition, pervasive poverty, racism, sexism, and more.           

Amidst all this, we follow Phil Ennen, the CEO of this hospital (CHWC--for Community Hospitals and Wellness Centers) in Bryan. He wants to rely on his local, traditional values of “we can fix this,” but now he must confront the threats of national hospital chains, the need to cut staff and services, and the seductive lures of adding for-profit and high-tech services. Eventually, he sees no path forward and accepts the board’s invitation to retire. His replacement will have all the same problems.           

A closing section sees the arrival of Covid-19, a threat to this hospital and, of course, the nation at large. Alexander writes, “the virus seeped into the fault lines created by American pathologies. The country had changed from being an ongoing project to improve democratic society and live humanistic ideals to being a framework for fostering corporate profit” (p. 268).  

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Three Poems by Felice Aull

Aull, Felice

Last Updated: Jul-12-2021
Annotated by:
Davis, Cortney

Primary Category: Literature / Poetry

Genre: Poetry

Summary:

Poet Felice Aull has three poems in "Lullabies & Confessions," an anthology of poems about parenting published by University Professors Press. In her poems, Aull often bravely sheds her professional mantle to reveal personal experiences, deeply observed.

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East West Street and Ratline

Sands, Philippe

Last Updated: Jun-28-2021
Annotated by:
Trachtman, Howard

Primary Category: Literature / Nonfiction

Genre: History

Summary:

The literature on the Holocaust is vast and has been examined from every angle. One might think that nothing more could be written on the topic or that there could be no new perspectives on this horrific event that occurred less than 100 years ago. But Philippe Sands would prove you wrong. In these two linked books, he tells an extraordinary real life story that combines personal experience and world history into a narrative that is as powerful as any novel.

East West Street is the first in this unplanned sequence of books. It recounts how Sands received an invitation to an academic conference and traveled to Lemberg, Poland (modern-day Lviv, Ukraine), where his family came from. His seemingly clear-cut goal was to understand what happened to his relatives and why his grandfather Leo Buchholz was the only survivor. As he digs deeper into his family’s tragic story, he learns that two men, Hersch Lauterpacht and Rafael Lemkin, attended the same university in Lemberg as his grandfather and at about the same time after World War I.  The three men did not know each other and Lauterpacht and Lemkin are not household names. However, Sands underscores their importance in coming to grips with the Holocaust and skillfully weaves the two men’s stories together.

As his grandfather struggled to escape the ravages of the German occupation of Europe, Lauterpacht and Lemkin were already thinking about how to punish the Nazis for their wartime crimes. According to international law before these two men arrived on the legal scene, state sovereignty was uncontested and leaders could do whatever they wanted to their citizens without fear of external intervention. Lauterpacht coined the term “crimes against humanity” to provide an international framework to prosecute the Nazi leaders, and Lemkin devised the term “genocide” to create a new crime that transcended national boundaries. Sands describes how these two vastly different men struggled to get their terms incorporated into the formal charges against the Nazis by the team of lawyers that represented the victorious nations at the Nuremberg tribunal. In the course of his investigation, Sands meets Niklas Frank, the son of Hans Frank, who supervised the extermination of the Jewish population in Lemberg and the surrounding area and who was one of the 23 defendants in the Nuremberg trial. Niklas is contrite and rejects his father because of his monstrous crimes. However, he introduces Sands to Horst Wachter, the son of Otto Wachter, Hans Frank’s chief deputy, who was primarily responsible for implementing the Final Solution on the ground.

This is where Ratline picks up the tale. In this sequel, Sands describes in more detail what happened to his own family, while Otto Wachter climbed higher in the Nazi hierarchy. Sands describes Wachter’s growing family and his infidelities. He documents how his wife ignored Otto’s behavior and military activity while benefiting from all the perks that came her way because of her husband’s efficiently murderous success. Wachter was forced to run for his life when the war ended and spent almost a year hiding out in the mountains of central Europe to escape capture. When it appeared safe, he traveled to Rome to take advantage of the “ratline” of the title to escape and find refuge in South America. Through the conniving of Vatican officials, American counterintelligence officers, and others he almost succeeded. But he died in mysterious circumstances before he could leave Rome. There is an extraordinary and logic-defying linkage between the families that comes to light because of Sands’ meticulous detective work, and it rivals anything a screenwriter could dream up.

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Annotated by:
Schilling, Carol

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Crip Camp: A Disability Revolution is an exuberant film by and about people who have been marginalized on screen and in their lives. It opens with black and white archival footage of Camp Jened, a quirky, free-spirited, counter-culture summer camp for disabled teenagers in New York’s Catskilll Mountains. One camper called it a utopia. The second and longer part of the film follows several former campers into their adult lives. They become parents, spouses, professionals, and disability rights activists at a crucial historic moment for disability legislation. Both parts of the film propose that the liberty and solidarity experienced at Jened emboldened several of the campers to seek opportunity and equality, for themselves and others, in the world beyond their camp.

Located near Woodstock, geographically and culturally, Jened offered a space free from the discrimination the summer residents encountered elsewhere. Campers could engage in uninhibited physical activities, uncensored storytelling, self-governance, mutual caretaking, real friendships, irreverent insider humor, romance, and fun. One powerful scene allows viewers to overhear campers with diverse disabilities share common experiences: being disrespected or ignored at school, overly protected at home, isolated everywhere. Another tracks the campers’ hilarity and pride over an outbreak of “crabs.” One camper declares his counselor’s demonstration of how to kiss, “Best physical therapy ever!” 

While the film’s co-director, former camper Jim Lebrecht, narrates the film, Judy Huemann is its political and moral center. A wheelchair user, she rose from camper to counselor. Huemann was revered around camp for successfully suing the New York City Department of Education for the right to teach. She and several post-campers reunited in Berkeley, California, where they became involved in the Independent Living Movement. An astute leader, Heumann is represented as central to a remarkable 25-day sit-in at the San Francisco Department of Health, Education and Welfare (HEW) offices in 1977. She and her disabled colleagues risked their health and their lives—they slept on the floor and improvised medical necessities—to convince HEW to approve regulations essential for enforcing the anti-discrimination section of the 1973 Rehabilitation Act. The scene of Heumann’s standoff with the HEW representative is unforgettable. As are the deliveries of food, supplies, and solidarity that the Black Panthers and other marginalized groups in San Francisco provided daily. Other archival footage, including of Heumann and demonstrators stopping traffic in New York City to demand accessible taxis and of protestors abandoning their wheelchairs to pull themselves up the steps of the nation’s Capitol, are startling images of the struggle to secure disability civil rights in the United States. Recently filmed interviews with several of the former campers affirm that, despite the work toward disability justice that remains, they live fuller, more vibrant lives as a result of their experiences at Jened and the legislation they insisted on.

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Joji

Pothan, Dileesh

Last Updated: Jun-13-2021
Annotated by:
Teagarden, J. Russell

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

“Grandpa is in quarantine,” Popy tells the delivery man through his face mask in the opening scene. His grandfather was not in quarantine; Popy had ordered an air gun using his account and now needed to conceal it from him. But, because the movie is set during the Covid-19 pandemic, the delivery man could easily believe Popy’s story and hands over the package with the gun.  

Popy is a teenager living in a multigenerational household in India, which in addition to his grandfather, Kuttappan PK Panachel, includes his father, Jomon, two uncles, Jaison and Joji, and Jaison’s wife, Bincy. They live on a sprawling and prosperous plantation Kuttappan owns near Kerala. Imperious and parsimonious, Kuttappan keeps tight control over his domain and family. As the movie begins, we see cracks forming in the family from the continuous pressure he exerts. The pressure affects Joji most.

Though he dropped out of an engineering college, Joji seeks wealth and independence, but his attempts to attain riches yield little until Kuttappan suffers a stroke. From the time of his father’s struggle for survival until his death, Joji plots to hasten his father’s demise and secure the family fortune for himself. Lives are lost, and so are Joji’s aspirations. 

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Transcendent Kingdom

Gyasi, Yaa

Last Updated: Jun-07-2021
Annotated by:
Trachtman, Howard

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Can scientists be religious? Is Religion or Science best able to deal with the psychological problems that can arise over a lifetime? Yaa Gyasi’s powerful new book, Transcendent Kingdom, aims to answer these perennial questions. Gifty, the precocious daughter of two Ghanaian immigrants, is the narrator and the main character in this novel. She grows up in Huntsville, Alabama where her parents settled after moving to the United States. Her mother works as home health aide and her father is a manual laborer. Gifty’s older brother, Nana, is a talented athlete who excels in basketball and becomes the leading scorer and star of his high school team. Religion is a key element in the mother’s worldview, and she impresses this on Gifty.  The mother and daughter attend an evangelical church, and both are convinced that they can feel the presence of God, that he speaks to them, and helps guide their life. The father, called the Chin Chin Man, becomes homesick for Ghana and leaves the family to return his birthplace.

With the nuclear family reduced to three and her mother overworking to earn enough to care for her children, young Gifty assumes major responsibility for her older brother, Nana. He suffers an ankle injury during a basketball game. Unfortunately, playing out a common script, he is given a prescription for oxycodone to control the pain. The prescription is renewed and Nana, like so many others in similar situations, becomes addicted and ultimately succumbs to a heroin overdose. The family is now a twosome. In parallel with the family saga, Gifty is a graduate student in neuroscience at Stanford after a successful college career at Harvard. Her mother moves in with her because of extreme depression. Gifty is working on mice using state-of-the-art methods to map the neural pathways that control reward-seeking behavior.  Her research effort is motivated by an attempt to understand her mother, who has almost no reward- seeking behavior due to her depression, and her brother who could not suppress his reward-seeking activity. The story is filled with emotionally wrenching episodes that fill in the details of the main characters. The ending is surprising but provides a satisfying resolution to Gifty‘s approach to life and her challenges with her family members’ experience with overwhelming psychiatric disease.

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Annotated by:
Field, Steven

Primary Category: Literature / Nonfiction

Genre: History

Summary:

John Barry’s The Great Influenza is a deep dive into the history of the influenza pandemic of 1918.  But it is not simply a deep dive into the purely medical aspects of that history—as no medical histories truly are—but is in addition an exploration of the social and political currents of the time that coexisted with and facilitated the pandemic. 

Although his story opens with the establishment of the Johns Hopkins Hospital in 1876, Barry immediately takes a detour into the history of medicine dating back to Hippocrates, and traces the history of medical/scientific thought from Ancient Greece to the end of the 19th century.  He then introduces a series of physicians, scientists, and medical researchers who will play their parts in the story of the pandemic (this first section is called “The Warriors”) and outlines their training, research, and interactions.

It isn’t until page 91 that he takes us to the rural Kansas county in which the story of the pandemic begins.  For although it was called the “Spanish Flu,” that was actually an eponym of convenience; in fact, the first cases of pandemic flu seem to have arisen on the American prairie.  However, newspaper reporting on the new pandemic was felt by the Allies and Central Powers alike to be contrary to the public interest (the war was still raging), so it was left to neutral Spain, whose king had come down with the disease, to publish the early reports.  In this section, “The Swarm”, Barry also briefly reviews the basic (not to worry, very basic) microbiology of viruses and the history of some prior pandemics.  He follows this with the section called “The Tinderbox,” in which he traces the events leading up to the entry of the United States into World War I, and the importance of that war and the political and social conditions surrounding it in the history of the pandemic.  From here on in the influenza itself takes center stage; in sections called “It Begins,” “Explosion,” “Pestilence,” “The Race,” and “The Tolling of the Bell,” the rapid and lethal course of the pandemic is described in gripping (no pun intended) detail.  The last two sections discuss the scientific advances (and some false starts) brought about by the cadre of researchers working day and night to tame the outbreak, and then Barry finally turns to the retreat of the virus and ultimate end of the pandemic.  The book ends as it began, returning to the stories of the individual men and women of science who engaged in the battle to beat the disease of which it had initially been said by many that “[t]his was, after all, only influenza.”  

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