Showing 1 - 10 of 463 annotations tagged with the keyword "Cancer"

Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Nonfiction

Genre: Autobiography

Summary:

All the [medical] world’s a stage! In elegant prose, with Felliniesque flights into whimsical metaphor, physician-historian-playwright Charles Hayter describes his encounters with cancer, as a doctor and as a son, and how the experience changed him as a person. 

Just as he finishes his residency training as a cancer specialist, his stoic physician father develops cancer. The story of that family illness is interwoven with vivid case histories of patients, recounted personally rather than clinically. These patients display many of the characteristic reactions and behaviors of his own father. 

Several other themes are prominent: the losing battle against death – or rather Death--who is a character lurking in the corners of the consultation rooms; the tensions of a son trying to please his difficult parents with advice and understanding that they seem not to want; the bravery of a gay man coming out to his wife and children to find a new place in the world. 
 

These struggles are placed on a background of the nebulous status of radiation therapy, a maligned and misunderstood specialty.

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Editing Humanity

Davies, Kevin

Last Updated: Jun-28-2022
Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: History of Medicine

Summary:

Editing Humanity explores the history, biology, sociology, and ethical import of CRISPR (“clustered regularly interspaced short palindromic repeats”), the major new DNA technology indicated in the book’s subtitle, “The CRISPR Revolution and the New Era of Genome Editing.”  Using CRISPR, researchers can manipulate the DNA of animals, plants and microorganisms with extremely high precision. In particular, scientists now have the potential to customize the human genome.  

What is CRISPR? To quote Davies, “CRISPR is a small subsection of the bacterial genome that stores snippets of captured viral code for future reference, each viral fragment (or spacer) neatly separated by an identical repetitive DNA sequence.” (p. 23) When the cell is reattacked by a virus, an RNA copy of that virus’ stored “signature” forms a DNA-splitting complex that destroys the incoming virus. In 2012, Jennifer Doudna, of the University of California, Berkeley, and Emmanuelle Charpentier, of the Max Planck Institute, Berlin, demonstrated that CRISPR could be engineered to edit any gene. One could, for example, replace a disease-causing mutation in any DNA segment with the healthy variant, thus preventing genetic disease.  

The author, Kevin Davies is a geneticist and science writer whose previous books include Cracking the Genome and DNA: The Story of the Genetic Revolution.  In Editing Humanity, he discusses an array of actual and potential applications of CRISPR technology, including human disease prevention by altering susceptibility of animal vectors, improving farm productivity, and even resurrecting extinct species. However, the most powerful and controversial topic is genetic manipulation of the human embryo. Davies devotes several chapters to the cautionary tale of the young Chinese scientist He Jiankui who engineered the world’s first gene-edited babies, and the scandal and disgrace that followed. (He was convicted in China of “illegal medical practice” and sentenced to prison.)

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Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

After 65 years of marriage, two life-partners face the prospect of final separation, as one of them develops multiple myeloma. This is the crisis that led Irvin Yalom, eminent psychiatrist, novelist, and pioneer of existential psychotherapy, and his wife Marilyn, acclaimed feminist author and historian, to collaborate in writing the story of their journey through Marilyn’s final months of life. In the resulting book, Irvin and Marilyn write alternating chapters until Marilyn becomes unable to write. After her death, Irvin continues with the story of his bereavement.  

Marilyn’s chapters include reflections on love and illness, ranging from Emily Dickinson and Henry James to Paul the Apostle. She frequently expresses her gratitude: “I can still talk, read, and answer my emails. I am surrounded by loving people in a comfortable and attractive home.” (p. 20) Most of all, she is thankful for her husband, “the most loving of caretakers.” (p. 15) Yet, as her disease progresses, she comes “to the understanding that I would never be the same again—that I would pass through days of unspeakable misery while my body would decline and weaken.” (p. 76) She decides to pursue the option of physician-assisted suicide, which is legal in California, when her suffering becomes overwhelming.  

In his chapters, Irvin resists this decision, maintaining hope for additional “good” life, despite all evidence to the contrary. Near the end, Marilyn’s pain and other symptoms become so severe that she cries out, “It’s time, Irv. It’s time. No more, please. No more.” (p. 139) Her physician arrives, confirms her intention, and surrounded by her whole family, Marilyn sucks the liquid through a straw and quietly passes away.

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Ward Rounds

Beernink, K. D. (Kenneth Dale)

Last Updated: Apr-25-2022
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

This is a collection of poems about patients, written by a young physician in the late 1960s. The book is organized around the theme of a hospital ward. Each poem is named for a patient and has the patient’s disease as its subtitle. The poet composed these poems during his own illness when, as he says in the original Introduction, “my patients reappeared to me, and I lived again in my mind all the many emotions we experienced together.” K. Dale Beernick died of chronic myelocytic leukemia at the age of 31 in 1969. In Ward Rounds he recounts his experiences as a medical student and house officer. He uses a variety of forms and techniques, including rhyme, blank verse, haiku, and even one villanelle. The poems vary in quality and impact. Among the best are "Penny Brown" (rheumatic heart disease), "Theodosus Bull" (delirium tremens), "Anonymous" (spontaneous abortion), and "Minnie Freeme" (post-necrotic cirrhosis).  

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Daughter

Davis, Cortney

Last Updated: Jan-17-2022
Annotated by:
Shafer, Audrey

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

Davis, a nurse practitioner, chronicles her daughter’s life, illness and death at age 54 from cancer. The book consists of three sections, with poems unevenly divided such that of the 30 poems, only one rests in section II. Titled Windmill, this poem forms a fulcrum between the relationship of mother and daughter to one of mother and ill daughter. The windmill is a small gift from her daughter – a reminder of Kansas where the daughter, her husband and children live, thousands of miles from Davis. The collection begins with her ‘soon-to-be born daughter’ (page 15) and ends with The Sacrament of Time, dated months before her daughter’s death from, at this point, a widely metastatic breast cancer. The final poem holds within it an entire world – the birth of the daughter, the fraught frantic mother-to-be pleading for help, the birth of a healthy baby girl, the wonder of the new addition to their family, the travel with the newborn to home, and a reflection on what poems can and cannot do. “Poems cannot // save us, Amichai said, but all I have are these poems” (page 58).  

If the first section details the many ways unconditional love for a child unfolds, through wonders of babyhood, delights of childhood, the harsh lessons of adolescence, and the successful launch, the final section underscores how deep that love runs. As the cancer illness progressed during the pandemic, issues of separation became more acute. Davis marks the numbers affected (illness and death) by coronavirus (SARS-CoV-2, COVID-19) during the pandemic, as her poems follow her daughter’s cancer. These numbers, along with brief quotations from her daughter’s scans and reports, lend a contrast to the evocative imagery and experience of illness in a loved one. Medical mistakes are chronicled as well (see What a Terrible Mistake).  

The collection is dedicated to Davis’ daughter and her daughter’s children. Even the title, Daughter, calls to her, as if addressing her daughter directly. The title also serves to universalize the parenting of a daughter, even as the particulars of this family are detailed.

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Queen of the Sugarhouse

Studer, Constance

Last Updated: Sep-14-2021
Annotated by:
Davis, Cortney

Primary Category: Literature / Fiction

Genre: Collection (Short Stories)

Summary:

Constance Studer's engaging "Queen of the Sugarhouse" contains nine short stories ranging in length from 9 to 21 pages, each story complete in itself.  Her nursing expertise is evident in several stories, including "Mercy" (page 3), "Shift" (page 77), "The Isolation Room" (page 95), "Testament" (page 112), "Special Needs" (page 122), and the title story, "Queen of the Sugarhouse" (page 138). 

While many of the stories specifically revolve around medicine or nursing, others examine a variety of issues, often with healthcare peripherally involved. 

In "Shelter" (page 21), a homeless vet who served in the Gulf War struggles with PTSD, the difficulty of obtaining permanent disability, the inability to find work or a suitable living space, and his quest to find treatment for his many physical problems after chemical exposure during Desert Storm.  He sees a different doctor at each appointment and no one truly helps him. "Finding today's meal or bed or beer takes all my energy, leaving me nothing left over for thinking about next week.  I am a veteran and can no longer vote because I have no home" (page 27).  Studer takes us into this man's life and struggles with clarity and empathy.


"Think Beauty" (page 37) questions what makes a woman beautiful (or believe she is beautiful) against a back story examining friendship and all that entails.  "This Middle Kingdom" (page 58) tells a story that encompasses both the heroics of a ski team that saves skiers in distress and how difficult it can be to feel compassion for those who end up in trouble because they flaunt the rules or advice of the experts--a theme quite relevant for our times. 

The book's opening story, "Mercy" (page 3) explores a nurse's various reactions after she makes an error while dispensing medication. As in every story in the collection, multiple themes weave in and out, driven by a character's decision or dilemma.  In "Mercy," we see how medical personnel can truly care for and worry about their patients; how even a small error may cause a nurse deep distress, both for her patient and for her future; how the nursing shortage leads to burnout; and how "real life" continues on in the background, in this case, a passionate love affair that leads both to marriage and to grief.  "Grief is a train that doesn't run on anyone else's schedule" (page 15).

"Shift" (page 76) tells of a physician who is devoted to his work and his patients in the ER ("His white coat flaps, stethoscope bounces as the doctor runs, its weight a comfort, like a rosary for a priest" page 76) while his wife feels neglected.  The story moves between the chaos of the ER and the story of his marriage, a love that began when the doctor was in medical school.  After his wife leaves him, the doctor sleeps with the lights on, hoping she will return.  But whenever he closes his eyes, he only sees scenes from the ER.  The story ends with words the doctor has said so often to a patient: "Please sir, lie still.  I'm going to numb you now.  Hang on, man.  Soon the pain will be gone" (page 93). 

"The Isolation Room" (page 94) follows a woman, a writer, who has been, she believes, placed unnecessarily and mistakenly in a psychiatric ward.  As we read, we wonder if this woman is truly afflicted with a mental disorder or if she is simply extremely imaginative, perhaps betrayed by her husband who arranged for her admission. The main character is likeable, often seemingly sensible, perhaps incredibly but differently talented: "Maybe to be out of her mind meant she'd finally make the leap from logical to intuitive, into her true skin, a room all her own ... a writer, that teller of lies, pursuer of truth by means other than logical, that follower of breadcrumbs through the scary forest wherever they lead?" (page 97).


"Testament" (page 112) follows a student nurse in her first month of training and touches on the care of difficult patients, their various religious beliefs, and how healthcare providers' families are not immune to illness. "Special Needs" (page 121) follows Maria, a waitress with an unexpected pregnancy and wheelchair confined brother. The title story, "Queen of the Sugarhouse" (page 137) is a poignant examination of breast cancer; the terrible trial of chemo and radiation; the complex relationship between the suffering mother and her daughter, a nurse; and how life changes when the drama of uneasy but genuine love and relationship ends.  "I think I hear Mama's voice, then
realize it's only the sound of water over rocks.  Tears are this river carrying me forward" (page 153).


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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:

Elizabeth Siegel Watkins reports on the use of estrogen alone and in combination with progestin for women during menopause and after menopause from the 1890s until the book was published in 2007. She concentrates on the sixty years between 1942 and 2002. The event Watkins uses to mark 1942 as an important moment is the U.S. Food and Drug Administration (FDA) approval for the estrogen product Premarin as hormone replacement therapy (HRT) in women with menopause symptoms. The event she uses to mark 2002 is the release Women’s Health Initiative (WHI) findings that showed estrogen is not the “elixir of life” that many thought it was then.  

Watkins builds her story off the trajectory of estrogen use during this sixty-year period, which spanned two peaks followed by two crashes. The estrogens for HRT first crested in the early 1970s before its use dropped dramatically in 1975 on uterine cancer fears. Estrogen use began to rise in the early 1980s on regained confidence from combined use with progestin to reduce uterine cancer risk and from hopes that bone loss could be prevented and even reversed. This resurrection continued through the 1990s as estrogen use during and after menopause became “associated with reduced risk of colon cancer, prevention of tooth loss, lower incidence of osteoarthritis, increase in bone mass, reduced risk of Alzheimer’s disease, and lower rates of death from all causes” (p. 241). 
 

Based on surveys of prescribers and prescription data during this time, Watkins concludes that “physicians who saw menopausal women as patients were…enthusiastic prescribers of HRT” (p. 244). They remained enthusiastic, making Premarin the most prescribed pharmaceutical product through much of the 1990s and until 2002 when the WHI trial was stopped three years early because it showed that HRT failed to produce the expected benefits, and even worse.
Women who took the estrogen–progestin pills, as compared with those in the control group who took placebo pills, increased their risk of breast cancer by 26 percent (relative risk of 1.26), coronary heart disease by 29 percent (1.29), stroke by 41 percent (1.41), and pulmonary embolism (blood clot) by 213 percent (2.13). (p. 271)
The investigators advised clinicians based on these results, that HRT “should not be initiated or continued for the primary prevention of coronary heart disease” (p. 271). Watkins quotes an editorial from the Journal of the American Medical Association that went further in saying that the trial “provides an important health answer for generations of health postmenopausal women to come—do not use estrogen / progestin to prevent chronic disease” (p. 273). HRT prescriptions plummeted.  

These clinical inputs into the trajectory of estrogen are just the bare bones of estrogen history. Watkins fills in the story: 
The story of estrogen is woven from several strands: blind faith in the ability of science and technology to solve a broad range of health and social problems, social and cultural stigmatization of aging, shifting meanings and interpretations of femininity and female identity, and the pitfalls of medical hubris in the twentieth century. (p. 1)
Watkins weaves these strands into the story of estrogen, which she tells in a chronological fashion, often as the subjects of individual chapters. Some include: the implications of rising feminism; pharmaceutical company promotional activities; the roles of patient advocacy organizations; FDA requirements for patient information about prescription drugs; generational differences in views of menopause; evolving research methods and evidence standards; and cultural shifts and mainstream media influences. 

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Mercy

Montgomery, Judith

Last Updated: Mar-27-2020
Annotated by:
Davis, Cortney

Primary Category: Literature / Poetry

Genre: Poetry

Summary:

"Mercy," winner of the Wolf Ridge Press Narrative / Poetic Medicine Prize, contains nineteen powerful poems--poems that provide an intimate look into the author's role as caregiver to her husband who is living with, and being treated for, liposarcoma.  But the poems in this small volume are not just about husband and wife.  Cancer becomes a third character, one who is often addressed as a presence lingering in the same house, sleeping in the same bed, never absent from every moment of struggle or from any moments of joy.  In the opening poem, "Cozy" (page 1), the couple has "escaped" to a remote rented cabin.  They slip "from love-rumpled featherbed and sheets" feeling "safe" within the sturdy cabin walls that "keep out driving rain or freeze."  For those hours, nothing can spoil their happiness, "even Cancer, who squats on our stoop, / flipping his gold coin in lazy arcs."  At the close of "Cozy," as the couple drives home from their respite, Cancer rides with them, sitting between them "as he hums and nods / pleasantly--first to you, then to me, // one hand lightly resting on each near thigh."  The author weaves this threatening image of Cancer as an ever-present entity throughout the poems that follow.

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Man's 4th Best Hospital

Shem, Samuel

Last Updated: Feb-28-2020
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Most of the group are reunited in this sequel to the 1978 blockbuster, The House of God: narrator Dr. Roy Basch and his girlfriend (now wife) Berry, former fellow interns (Eat My Dust Eddie, Hyper Hooper, the Runt, Chuck), surgeon Gath, the two articulate police officers (Gilheeny and Quick), and the Fat Man (a brilliant, larger-than-life former teaching resident). As interns, Basch and his comrades were a crazy, exhausted, cynical crew just trying to survive their brutal internship. Years later, the midlife doctors have changed but remain emotionally scarred.

The Fat Man (“Fats”), now a wealthy California internist who is beginning a biotech company targeting memory restoration, is recruited to reestablish the fortunes – financial and prestige – of Man’s Best Hospital which has slipped to 4th place in the annual hospital rankings. He calls on his former protégés to assist him in an honorable mission, “To put the human back in health care” (p34). Fats enlists other physicians (Drs. Naidoo and Humbo) along with a promising medical student (Mo Ahern) to staff his new Future of Medicine Clinic (FMC), an oasis of empathic medical care that strives to be with the patient.

Every great story needs a villain. Here the main bad guys are hospital president Jared Krashinsky, evil senior resident Jack Rowk Junior, and CEO of the BUDDIES hospital conglomerate Pat Flambeau. The electronic medical records system dubbed HEAL is a major antagonist, and the FMC docs wage war against it and the “screens.”

Poor Roy Basch works long hours, deals with family problems, has trouble paying bills, and experiences health issues (a bout of atrial fibrillation, a grand mal seizure, and alcohol use). Fats has warned of a “tipping point when medical care could go one way or another, either toward humane care or toward money and screens” (p8). Alas, the computers and cash appear victorious. A major character is killed. Many of the doctors working in the FMC including Basch leave the clinic. And fittingly, Man’s Best Hospital plummets in the latest rankings from 4th to 19th place.

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