LitMed: Literature Arts Medicine Database

The Hours

McDermott, Phelim

Last Updated: Feb-13-2023

Brungardt, Gerard

Primary Category: Performing Arts / Theater

Summary:

This annotation is based on a live streamed performance (The Met: Live in HD) presented by the Metropolitan Opera at the Metropolitan Opera House in New York City that ran November-December of 2022. It is based on two novels: The Hours by Michael Cunningham and Virginia Woolf's Mrs. Dalloway.

The Hours follows a day in the life of three women living in three different eras in three different parts of the world. Each woman is wrestling with her own demons, which overlap with those of the others, while simultaneously remaining distinct. Clarissa is a book editor in late 20th century NYC readying for a party she is hosting that evening in honor of Richard, a writer and her former lover who is dying from AIDS. Laura is a housewife and mother in 1940's LA preparing with her son to celebrate her husband's birthday. The final character is Virginia Woolf herself in 1920's London writing her novel Mrs. Dalloway.

In each of these three narratives the central characters suffer depression, despair, loneliness, regrets, unrequited love, and suicidal longings — particularly poignant is the portrayal of each woman's aching despair in trying to discern who she herself is.

As each of the women's stories is told, the full power of the medium of opera is brought to bear. In particular, there are several scenes where two (or even all three) of the characters' stories run concurrently with alternating dialogue (e.g., Woolf voices her novel as she writes it while Laura reads aloud the same passage). Characters walk into each other's scenes. The chorus is used throughout as a kind of human milieu that gives voice to inner thoughts and feelings, even engaging in dialogue with their character. The dialogue, color palette, wardrobe, and musical style are unique and specific to each scene/period/story. Woolf's is a drab color palette and dark music; Laura has bright post-war colors and a popular music style evoking Lawrence Welk or Henry Mancini. Clarissa's world is 90's Americana with hints of Bernstein and Copland in the music.

View full annotation

Sinkhole

Patterson, Juliet

Last Updated: Jan-18-2023

Glass, Guy

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

The first few pages of Sinkhole recount the final moments of the author’s father’s life, as the author imagines they occurred. Slipping away from the bedroom where his wife sleeps, her father writes a note and leaves the house for the last time. It is nearly zero degrees in Minneapolis as he proceeds to the park where he usually walks his dog. All of this has been methodically planned: “My father chooses to die on the north end of the bridge. There, the canopy is so dense that, from the street, the structure appears to grow from the hill. In the dim light spreading from the railings, the crown of its arch bestows darkness” (p.4).

Immediately following her father’s suicide, author Juliet Patterson is, naturally, overcome. After the initial shock, she begins to wonder about her father’s motivation. She realizes she did not know him as well as she had thought. Theirs is a family that “rarely talked about important things” (p.9). One of those things is that both her father’s father and mother’s father had also taken their own lives. She begins to ask questions: “Who were these men? What led to these deaths in my family? What did my family’s history of suicide imply? And what did it mean for my own future?” (p.10) The remainder of Sinkhole tells the story of how the author investigates the death of her grandfathers, a quest that takes her back to her family’s ancestral home in Kansas.

One day, on an impulse, the author locates her grandmother’s abandoned house. Like other properties in this part of the country where there were formerly mines, it has fallen into a sinkhole. She sees the “terrifying alien world of a sinkhole” (p.111) as a metaphor for “a realm that I could not enter,” as she struggles to make sense of her family’s past. Eventually she undergoes a transformation and comes to terms with her loss. The least she can do to break the cycle is to be honest about her family history with her young son.

View full annotation

Strangers to Ourselves: Unsettled Minds and the Stories That Make Us

Aviv, Rachel

Last Updated: Oct-18-2022

Glass, Guy

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

When Rachel Aviv, the author of Strangers to Ourselves, was six years old, she simply stopped eating. She said she got the idea from the Yom Kippur fast. She was promptly checked into a psychiatric hospital where she became one of the youngest-ever patients to be given the diagnosis of anorexia. Through associating with older, more seasoned anorexic girls she became a sort of “anorexic-in-training” (p.13). Fortunately, after a few months she snapped out of it, and was discharged. She never suffered from the same symptoms again.

As an adult, Aviv began to think about what had happened to her. The only remnant of her experience was a diary entry from age 8: “I had a diseas called anexexia” (p.231). Had she even had the disorder, or had the diagnosis been a mistake? Why had she not gone on to have “an anorexic ‘career’” (ibid.), while one of the girls who had mentored her ultimately died of anorexia-related causes? In order to answer these questions for herself, Aviv meets with the therapists who treated her more than thirty years ago as well as with the family of her deceased copatient.

As a result of Aviv’s introspection, she becomes intrigued by people whose psychiatric diagnoses do not fully capture the complexities of their situation. Strangers to Ourselves presents detailed case histories of several such individuals. Bapu is an Indian woman whose visions have caused her to be diagnosed with schizophrenia. Are they delusions, or is she a mystic? Naomi is a socially disadvantaged black woman who has struggled unsuccessfully to get ahead. During a manic episode, she jumps into a river with her young twins, one of whom dies. Her claim that “white people are out to get me” (p. 146) is ignored because her doctors insist that “delusions couldn’t on some level make sense” (p. 150). Yet another woman, Laura, bounces from diagnosis to diagnosis, and sleeps fourteen hours a day because of all the medication she is on. She becomes one of these people who no longer even know if their lack of functioning is “due to their underlying disorder [or] the heavy medications they’d taken for it” (p. 203).

View full annotation

One Friday in April

Antrim, Donald

Last Updated: Feb-08-2022

Glass, Guy

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

As One Friday in April opens, we find Donald Antrim in an agitated state on the roof of his Brooklyn apartment building. He paces, and alternately climbs down the fire escape, hangs from the railing, and lies on his stomach peering over the ledge. Repeated outpatient courses of psychotropic medication and psychotherapy have done only so much for his deteriorating mental state, and the situation has come to a head. Disheveled and wild-looking, he manages to return home whereupon his friends take him to a psychiatric hospital.

A MacArthur Fellow and author of several acclaimed novels, Antrim has previously published a memoir of his upbringing with his alcoholic mother. In this new memoir, flashbacks of childhood neglect and chaos are juxtaposed with the present day as he takes the reader through the acute phase of his illness: a lengthy hospitalization, a course of ECT, discharge from the hospital, rehospitalization, and eventual stabilization.

The author considers his condition to be suicide, noting that “depression is a concavity, a sloping downward and a return. Suicide, in my experience, is not that. I believe that suicide is a natural history, a disease process, not an act or a choice, a decision or a wish…I will refer to suicide, not depression” (pp. 14-15).

The book ends on a hopeful note. After several relationships that might be described as codependent, Antrim meets his current partner, whom he marries. He sees the roof of his building through his window and remembers a certain Friday in April but is comforted by the sound of his wife playing Chopin and Bach on the piano.

View full annotation

How To Be Depressed

Scialabba, George

Last Updated: Nov-28-2021

Glass, Guy

Primary Category: Literature / Nonfiction

Genre: Collection (Essays)

Summary:

How To Be Depressed is a book with a most unusual structure. It is introduced by an essay entitled “Intake” that was previously published in a literary magazine. The bulk of the book, “Documentia,” is taken up by an edited selection of the author’s psychiatric records from 1969 to 2016. It is rounded out by an interview with the author and by his “Tips for the Depressed.”

Author George Scialabba ascribes his “exceptionally flimsy…shock absorbers” to his “constantly worried” parents (p.3). While studying at Harvard he becomes involved with a strict religious organization. After leaving that group he undergoes a crisis of faith and his first episode of depression. Paralyzed by self-doubt, he drops out of graduate school and begins a cycle of clerical jobs that are beneath his intellectual capability. After many years he gradually wins distinction as a freelance essayist. However, due to his incapacitating symptoms he never has a steady writing job and has difficulty attaining financial security.

In his introduction, Scialabba tells us that “the pain of a severe clinical depression is the worst thing in the world. To escape it, I would do anything” (p.1). As attested to by the notes of his well-meaning psychiatrists and psychotherapists, he has diligently applied himself to a wide variety of treatments. Sadly, if anything he gets worse over time, and eventually requires electroconvulsive therapy.

View full annotation

Transcendent Kingdom

Gyasi, Yaa

Last Updated: Jun-07-2021

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.

View full annotation

Born to Be

Cypriano, Tania

Last Updated: Feb-26-2021

Glass, Guy

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Born to Be is a documentary about the trailblazing work being done at the Mount Sinai Center for Transgender Medicine and Surgery.

The film’s central figure is Jess Ting, a plastic surgeon who studied music at Juilliard before making a career switch to medicine. Scenes of him with patients are interspersed with domestic clips where he is at home with his children and playing the double bass. Just a few years ago Ting had never even performed a single gender-affirming surgery. He is the first to admit that he did not expect his career to take this turn: “Essentially, they just asked everyone else, and everyone said no except for me. Everyone thought I was nuts.” Be that as it may, Ting appears to have found his calling. In a short time, he has performed well over a thousand gender-affirming surgeries, pioneered new procedures, and helped to start a fellowship training program.

The stories of several of the Center’s patients are interwoven with that of Dr. Ting. One client, Cashmere, is a retired sex worker. Years of botched silicone injections have left her face chronically swollen. Now in her 50’s, she hopes to have the effects reversed, and to finally undergo the vaginoplasty she has been dreaming of her entire life. Another patient, Devin, 22, goes through a transition during the course of the film, renaming herself Garnet. Not withstanding strong family support, years of bullying in school have taken their toll as she struggles with depression.

View full annotation

Uncaring: How the Culture of Medicine Kills Doctors & Patients

Pearl, Robert

Last Updated: Feb-07-2021

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).

View full annotation

Prima Donna: The Psychology of Maria Callas

Wink, Paul

Last Updated: Feb-05-2021

Glass, Guy

Primary Category: Literature / Nonfiction — Secondary Category: Literature /

Genre: Biography

Summary:

Maria Callas, the most famous opera singer of the second half of the 20th century, continues to exert a fascination. Critical consensus is that Callas fused a technically flawed voice with an extraordinary stage presence to create something unique. More than forty years after her death, Callas’s recordings continue to be best-sellers, and her life has inspired dozens of biographies. Prima Donna: The Psychology of Maria Callas appears in Oxford University Press’s Inner Lives series, which consists of psychobiographies of artists that make use of current psychological theory and research. The focus of author Paul Wink, a psychology professor at Wellesley College, is adult development and narcissism.

The facts of Callas’s life are well known. She is born in New York City to an ill-matched Greek immigrant couple. Her father is barely able to keep a roof over their heads. Her mother Litza struggles to get over the death of an infant son, requiring hospitalization for a suicide attempt. As the story goes, Litza cannot bring herself to look at her new daughter for the first four days of her life. Litza, who imagines herself in a lofty social class, disdains their neighbors, and thus Maria is discouraged from playing with other children. When Maria is discovered to have talent, Litza exploits her.

As Litza’s marriage deteriorates, she brings Maria back to Greece. With the onset of World War II, they endure hardships. Yet, improbably, the overweight and awkward Maria shows a streak of brilliance. She is the hardest working student at the conservatory, quickly outpacing her peers. On Maria’s first day in Italy, where she gets her first big break, she meets a businessman who is more than twice her age. Within weeks they are a couple. For a time, she allows Litza to share in her success, even buying her a fur coat. But soon, in response to a request for money, she tells her mother to “jump out of the window or drown yourself” (p. 78), and then never speaks to her again.

Maria loses weight and transforms into the operatic counterpart to Audrey Hepburn. She enjoys one operatic triumph after another. Nevertheless, she becomes as famous for her bellicose and imperious behavior as for her singing. She kicks a colleague in the shin after a performance so she can take a solo bow. She is publicly fired from the Metropolitan Opera. She incurs scandal by suddenly canceling a performance at which the president of Italy is present.

When the fabulously wealthy Aristotle Onassis courts her, Callas unceremoniously rids herself of her husband. Soon, her technical flaws catch up with her, and her career dwindles away. Meanwhile, Onassis goes for a bigger trophy: Jacqueline Kennedy, and Callas is humiliated in the press. Voiceless, she exiles herself to Paris with her two poodles, develops an addiction to sleeping pills, and dies a decade later, alone.

View full annotation

Together

Murthy, Vivek

Last Updated: Nov-09-2020

Thomas, Shawn

Primary Category: Literature / Nonfiction

Genre: Longform journalism

Summary:

Since the first surgeon general was sworn into office in the 19th century, the Office of the Surgeon General has positioned itself as the leading voice on public health matters in the United States. In recent history, the office has had its highest profile campaigns rallying against issues such as tobacco use, obesity, and HIV/AIDS. Considering the combination of prevalence, morbidity, and mortality associated with these health issues, there is no doubt that any effort to stem the tide was a worthwhile endeavor.

When Dr. Vivek Murthy became the surgeon general in 2014, his office continued the historical campaigns against these health issues. At the same time, Dr. Murthy began investigating a looming epidemic within our borders: loneliness and social isolation.

It may be hard to convince the average person that loneliness is a problem of similar scale as tobacco use, obesity, or AIDS. There is no question that loneliness is unpleasant, even if it only lasts for a few moments. But the notion that one’s state of mind can predispose to disease or premature death somehow feels like a stretch. Addressing this skepticism, Dr. Murthy writes in his book about Dr. Julianne Holt-Lunstad, a psychologist at Brigham Young University who also faced a great deal of cynicism surrounding her research into the effect of social relationships on “everything from our behavior to our cellular function.” She had a breakthrough in 2010 when she published a massive study analyzing the health outcomes of over 300,000 participants, categorized by their degree of social connectedness. She found that social isolation was significantly linked to premature death, representing a risk nearly as serious as pack-per-day smoking, and more serious than obesity, alcohol use, and lack of exercise. Dr. Holt-Lunstad’s research spurred further studies which linked loneliness to heart disease, stroke, and depression, amongst other diseases.

These findings are hard to ignore, especially in light of the ongoing opioid addiction crisis and rises in teenage depression and suicide, all of which have been linked to loneliness and social isolation. In Together, Dr. Murthy weaves together scientific research, personal anecdotes, and current events to create a manifesto for tackling the next great public health crisis.

View full annotation