Showing 1 - 10 of 157 annotations tagged with the keyword "Epidemics"

Summary:

In Sweden, hundreds of children lie unconscious for months or even years in their homes or hospitals. Full neurologic evaluation, including MRIs, EEGs, and other studies reveal no abnormalities.  None of these children are Swedish. They are immigrants from the Near East or former Soviet republics, whose families are seeking permanent asylum in Sweden. If asylum is granted, the children gradually recover. Neurologists have named this mysterious illness “resignation syndrome” and classified it a functional neurological disorder.  

Suzanne O’Sullivan, an Irish neurologist, set out in 2018 to study children suffering from resignation syndrome, a project that led her to investigate other outbreaks of mysterious illness around the world. In The Sleeping Beauties, O’Sullivan discusses many such disorders, ranging from grisi siknis in Nicaragua (convulsions and visual hallucinations) to a form of sleeping sickness in Kazakhstan. These disorders have several features in common: absence of findings on medical and psychiatric tests, contagiousness (i.e. they seem to spread rapidly among populations in close contact), and significant morbidity.  

Dr. O’Sullivan notes “there is a disconnect between the way mass psychogenic disease is defined and discussed by the small number of experts who study it and how it is understood outside those circles.” (p. 257) The public finds reports of such illnesses difficult to believe. In the United States, we tend to believe that such illness, if it exists at all, occurs only in “backward” cultures and not in our enlightened society. On the contrary, the author presents “Havana syndrome,” as a case of mass psychogenic disease that first appeared among American diplomats in the Cuban capital in 2016. No consistent brain abnormalities have ever been found, and extensive study has ruled-out the possibility of a sonic weapon.  Dr. O’Sullivan believes that Havana syndrome is very likely a functional neurologic disorder occurring against “a background of chronic tensions within a close-knit community.” (p. 257)

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Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: History of Medicine

Summary:

The Invention of Medicine is both a scholarly history of early Greek medicine and a compelling mystery story. The “From Homer to Hippocrates” discussion (about 70 pages) is merely a prelude to the author’s main project, which is a careful analysis of the books attributed to Hippocrates of Cos. As a group, they have been associated with Hippocrates at least since the scholar Baccheios of Alexandra, writing in the 280s BCE, attributed them to him. The Roman physician Galen (about 170 CE) considered them products of a Hippocratic “school,” but believed they were written by many different authors, including in some cases, the great Hippocrates himself.  

The book’s highpoint is the author’s carefully reasoned hypothesis that the historical Hippocrates wrote the texts we now know as books 1 and 3 of the Epidemics, based on his practice experience in Thasos between 471 and 467 BCE. Other parts of the Epidemics were written by physicians up to several generations later who emulated Hippocrates’ naturalistic approach. The works identified as the “Hippocratic corpus” were grouped together as early as the 280s BCE as representing the school of Hippocrates because of their naturalistic, pragmatic, and ethical contents,  

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Fauci

Hoffman, John; Tobias, Janet

Last Updated: Mar-14-2022
Annotated by:
Yin, Ellen
Salman, Akbar

Primary Category: Performing Arts / Film, TV, Video — Secondary Category: Performing Arts /

Genre: Film

Summary:

“The Jesuit philosophy is ‘Men for Others,’” states Dr. Fauci, the titular subject of the documentary Fauci, as he explains how his public school experiences informed his medical career. Indeed, it sets the tone for the rest of a film that traces the beginning of Dr. Fauci’s career as an infectious disease physician through to his role in the creation of PEPFAR, the 2014 Ebola outbreak, and his present day responsibilities in the current pandemic. The documentary bounces primarily between the 1980s HIV/AIDS epidemic and the start of the COVID-19 pandemic in 2020. In both, we see that Dr. Fauci stands as a figure of great controversy, and we are shown his thought process in navigating the court of public opinion.

The film starts off interviewing Dr. Fauci about his childhood in Bensonhurst, Brooklyn where he was exposed to the Jesuit philosophy that would dovetail with his choice to go into public health service when he was drafted into the Vietnam War. Though he began his medical career with aspirations for a private practice on Park Avenue, Dr. Fauci realized that his true calling lay in “trying to figure out diseases that people were dying from” at the National Institute of Allergy and Infectious Diseases where he soon faced one of the greatest public health challenges of the 1980s – piecing together a way to combat a mysterious new disease that was killing more and more Americans. 

This, of course, sounds very familiar to the intended audience of the documentary. It is a parallel that Dr. Fauci himself is well aware of, stating that COVID-19 feels like a “diabolical repeat” of his experiences in the 1980s but that “the difference is [the] divisiveness dominating COVID-19 . . . we’re going to get through it in spite of this divisiveness and this politicization. We’re not going to get through it because of it.” The film leans heavily into this contrast, showcasing the evolving attitudes of many AIDS activists as Dr. Fauci went from “the enemy” to a man sitting in on ACT UP meetings and engaging in a dialogue that would culminate in a historic address at the 1990 International AIDS Conference – an address that highlighted the need for physician-scientists to incorporate the feedback of the individuals they were trying to help and reminded activists of the compassion that physician-scientists have for their patients. 

In the scenes taking place in 2020, we see an explosion of both positive and negative press coverage of Dr. Fauci as the COVID pandemic kicks into high gear. His inconsistencies regarding mask guidance, his direct challenging of President Trump, and his struggle to deal with increasing death threats against himself and his family are put on full display. The documentary does not shy away from showcasing Dr. Fauci’s vulnerability with multiple instances of a tearful Fauci recounting the deterioration of many of his AIDS patients and the “post-traumatic stress” that those experiences induced. These moments of vulnerability are threaded in with images of and commentary from his wife Christine Grady and his daughter Jennifer, a clear attempt to give us a sense of Anthony Fauci the human being and not just Dr. Fauci the public servant. 

As the film draws to a close, Fauci and his wife take a walk through the COVID-19 Memorial on the National Mall in Washington DC. “When you're involved in a race to stop a horrible disease, you always feel like you’re not doing things quickly enough, or well enough,” he reflects. “One of the most mysterious aspects of our universe is how viruses have transformed our civilization . . . And the one thing I can hope for . . . is that emerging infections do not inevitably become pandemics . . . I am optimistic that the lessons that we’ve learned will prevent that from happening.” After watching this documentary, it is an optimism that is easy to share. 

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Imprimatur

Monaldi, Rita; Sorti, Francesco

Last Updated: Nov-03-2021
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

In a future 2040, the church is considering the canonization of Pope Innocent XI. An unusual seventeenth-century manuscript is brought to the attention of the authorities and the bulk of the novel is its transcription in full.  

The manuscript is the diary of an intelligent, but inexperienced young orphan-apprentice who is working in a Roman hostel in September 1683. The Catholic Church is fighting the Ottoman Turks who have besieged Vienna. Tensions with France are high as that country and its king have long asserted their exemption from Church rule.

 A hostel guest dies, and the authorities, suspecting plague, impose a quarantine. The apprentice falls under the influence of another confined guest, Atto Melani, a famous castrato and spy for King Louis XIV of France. Believing that the deceased guest was murdered, they venture out each night into subterranean Rome searching for clues to support their theory and leading them to investigate poisons, panaceas, and political plots. Meanwhile, a physician also confined to the hostel attempts all remedies to prevent plague, while another guest, besotted with astrology, strives to reveal the future, and yet another plays soothing music. 

Like a baroque Agatha Christie novel, plausible suspicion is cast upon every guest until the truth emerges and with it many doubts about the saintliness of Pope Innocent XI. The 2040 writer invites the Holy Office to consider the implications of the manuscript before proceeding with the canonization.

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Annotated by:
Zander, Devon

Primary Category: Literature / Nonfiction

Genre: Biography

Summary:

The Impatient Dr. Lange is a biography of Joseph “Joep” Lange, an HIV/AIDS researcher best known for his work in HIV transmission prevention and treatment, written by Seema Yasmin.  Yasmin is a journalist, doctor, and epidemiologist whose life path was forever altered by a run-in with Dr. Lange at age 17, when he said to her, “If you want to help people, first you need to learn how to take care of them.  Go to medical school.” (p. xiii).  The book’s narrative parallels that of the life of her inspiration, Lange; in addition, Yasmin details the evolution of HIV, how it came to spread around the globe, and a history of antiretrovirals.  

Coming of age professionally in the early 1980s, Joep Lange had a career defined by HIV and the advances to manage it.  Early on, he trained as a physician before pursuing a PhD.  During his PhD, he was a prolific researcher, producing “eleven papers on AIDS in his first years,” including an early case study on the appearance of acute HIV and the way in which the body’s antibody response changes in response to continued infection.  His commitment to rigorous scientific inquiry continued as a professional research scientist.  Most noted for his early trials about the use of antiretrovirals and their role in preventing mother-to-child transmission of HIV, he was intimately involved with much of the science used to treat and prevent HIV today.  Outside of research, he was an ardent advocate of health equity, starting the PharmAccess Initiative, a group initially developed to expand access to antiretrovirals in developing countries.  

Ultimately, the book is about how a life of great potential, drive, and success was tragically cut short.  Shadowing the narrative of the book is the specter of Lange’s unfortunate end on Malaysia Airlines flight MH17, a plane that was mistakenly shot down over the Ukraine by pro-Russian separatists, while he was en route to the twentieth International AIDS Conference in Melbourne.  The penultimate chapter reflects on all that was unfinished - projects on three continents, advising the next generation of PhDs, a novel - and ends with a prescient quote from Lange, in regard to mandatory retirement in the Netherlands at the age of 65:  that even if he had 10-15 more years, he declares “that is still not enough time” (p. 174).

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An Enemy of the People

Ray, Satyajit

Last Updated: Aug-09-2021

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

In this 1989 Bengali-language film, the director and screenwriter Satyajit Ray presents an arresting contemporary reimagining of Henrik Ibsen’s 1882 play, An Enemy of the People. In Chandipur, India, Dr. Ashoke Gupta treats an increasing number of patients with hepatitis and jaundice. After some patients die, Dr. Gupta fears that the town could succumb to an epidemic. A water quality report reveals that bacteria contaminate local sources, and that the pollution lies in the town’s most populous area. Further complicating the crisis is Dr. Gupta’s determination that the holy water distributed at a new Hindu temple is culpable for sickening visitors. Eager to publish the findings in a local newspaper and advocate for the closure of the temple (a major pilgrimage destination) until the contamination is abated, Dr. Gupta must contend with his younger brother, Nisith, and other municipal bureaucrats and journalists who suppress his findings to protect the tourism revenue. The physician struggles to communicate medical information to a population deluded by religious superstition and deceived by avaricious leaders.

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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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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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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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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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