Showing 1 - 10 of 73 annotations tagged with the keyword "Law and Medicine"

One Child Nation

Wang, Nanfu; Zhang, Jialing

Last Updated: Apr-10-2020
Annotated by:
Jiang, Joshua

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Following the birth of her son, director Nanfu Wang’s foray into motherhood prompts her to consider her own upbringing in the shadow of China’s one-child policy. Starting from the experiences of her family and townspeople and extending to the policy’s international consequences, Wang documents the enormous cost of a social experiment that, when enacted in 1979, claimed to be absolutely essential for the economic salvation of the nation. Candid interviews with relatives, medical and governmental personnel, journalists, and activists are woven together with Wang’s personal musings on Chinese culture, civil liberties, and national memory. The film raises important bioethical questions, demonstrates a troubling intersection of medicine and the state, and confronts viewers with the realities of a policy that intruded into one of the most intimate aspects of a people’s humanity.

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The Little King

Rushdie, Salman

Last Updated: Dec-19-2019
Annotated by:
Galbo, Sebastian

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Dr. R. K. Smile, MD, founder of Smile Pharmaceuticals, Inc. (SPI), enjoys a sudden lurch into fortune and celebrity. Dubbed the ‘Little King’ by his Atlanta-based Indian community, Dr. Smile is a towering medical authority, philanderer and philanthropist, known to be both generous and avaricious. His pinnacle pharmaceutical coup, the patent that has earned him billionaire status, is InSmile™, a sublingual fentanyl spray designed for terminally ill cancer patients. Dr. Smile’s entrepreneurial vim, however, hardly stems from benevolent medical research, but rather an ‘excellent business model’ that he observed on a visit to India during which a Bombay ‘urchin’ handed him a business card that read, ‘Are you alcoholic? We can help. Call this number for liquor home delivery.’ The blunt practicality of building a market around sating addiction strikes the doctor as entirely sensible. Often wistful about India’s ‘old days,’ Dr. Smile fondly recounts the insouciance of neighborhood dispensary hawkers, their willingness to ‘hand out drugs without a doctor’s chit.’ Though admitting that ‘it was bad for [their] customers’ health but good for the health of the business,’ Dr. Smile yearns to replicate a similar culture of delinquent pharmacology, an unregulated market capable of profiting from supply-and-demand forces but indifferent to the wellbeing of its patrons. 

In the meantime, Dr. Smile’s wife, Mrs. Happy Smile, a simpering and daft socialite, envisions grand branding prospects that will globalize the Smile name through ostentatious publicity—inscribed name placards at the ‘Opera, art gallery, university, hospital […] your name will be so, so big.’ She refers to the worldwide reputation of the OxyContin family, the proliferation of the family’s name and esteemed place among prestigious cultural institutions: ‘So, so many wings they have,’ she says, ‘Metropolitan Museum wing named after them, Louvre wing also, London Royal Academy wing also. A bird with so, so many wings can fly so, so high.’ 

InSmile™ sales drive Dr. Smile’s burgeoning drug trade, as his prescription becomes preferred to conventional OxyContin highs due to its ‘instant gratification’ in the form of an oral spray. While SPI fulfills special house-calls for American celebrities and customers in ‘gated communities from Minneapolis to Beverly Hills,’ it also ships millions of opioid products to places such as Kermit and Mount Gay, West Virginia—communities, outside fictional contexts, that bear real-world vestiges of the opioid epidemic (West Virginia has the highest rate of drug overdose in the United States). Through a lecture series scheme, Dr. Smile bribes respected doctors to publicize and prescribe the medication, further entrenching the dangerous drug in medical circles.

As the SPI empire collapses following a SWAT-led arrest of his wife, Dr. Smile muses indignantly on his reputation and the ingratitude of his clients. Tugged again by nostalgia for the old country, he justifies his drug trafficking by likening it to quotidian misdemeanors, instances when one could circumvent the inconveniences of India’s law by knowing how to pull the venal strings of corrupt systems—like cutting a long ticket queue at the rail station, he says, by paying a little extra at a backyard office; or bribing government officers to stamp customs papers required to ship restricted antiques abroad—‘We know what is the oil that greases the wheels.’ With this deleterious mindset, combining nostalgia and entrepreneurial greed, Dr. Smile’s future is uncertain, but he is resolved to return—after all, he says, ‘I have lawyers.’

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Summary:

This illuminating and disturbing book explores how various forms of white supremacy became expressed in policies, laws, and elected officials, such as Donald Trump. Physician and sociologist Metzl details social changes in Missouri, Tennessee, and Kansas, where white Americans backed changes that, ironically, dramatically harmed them with gun suicides, school dropouts, worse healthcare, and shorter life spans. For Metzl, “Whiteness” refers not to skin color but to a political and economic system of white privilege.

Metzl's thesis that: “Trump supporters were willing to put their lives on the line in support of their political beliefs” was, in fact, a sort of “self-sabotage” (pp. 5-6). While a conservative political movement fostered white racial resentment, largely in lower-income communities, the mainstream GOP did its part by crafting policies against the Affordable Care Act, higher taxes, and restrictions on guns. An atmosphere of polarization and political stasis grew. Metzl writes: “Compromise, in many ways, coded as treason” (p. 11).  

Metzl focuses on the examples of Missouri, Tennessee, and Kansas to “suggest how the racial system of American fails everyone” (pp. 16, 20). He visits each state, leading focus groups, interviewing formally and informally, reading newspapers, and inductively formulating concepts that seem to explain the nonsensical behavior of rejecting helpful programs. For example, because “risk” in Missouri has become a code name for possible attacks by black people, white people buy guns, especially when restrictions are removed. Many white men feel that a gun (or many guns) restores their privilege, but suicide of white males, often low-income, goes up. Metzl’s statistics and charts show contrasts with other states with stricter laws and lower suicide rates. He calls for preventive medicine to lower such deaths.  

For Tennessee, the Affordable Care Act offered many benefits to poor or middle-income people, but Republicans (and especially Trump) attacked it as big government over-reach, socialism, exorbitant cost, a program that would help minority people, for example “welfare queens.” “Cost” became a proxy for the “we don’t like it,” even when the economics would be favorable for good healthcare for all. Blacks were generally in favor of ACA, but white blue-collar men swore by their independence and autonomy. Neighboring Kentucky accepted ACA, and ten graphs included in the book clearly chart the better outcomes for Kentucky in such areas as insurance coverage, death rates, and seeing a doctor.  

Metzl returns to Kansas, where he grew up and recalls the pride Kansans had in their state. Republican Governor Sam Brownback enacted massive tax cuts with large reductions to state services and school funding, an “experiment” in “epic defunding.” The GOP, Tea Party, Koch brothers, and “trickle down” theories all played a part in benefiting the wealthy financially, while minority and lower-income groups paid more. Infrastructure, such as roads, suffered. Untested charter schools collected wealthy white students, while public schools plunged in funding, test scores, and graduation rates (see 17 graphs). Since education is a predictor of health, there are and will be long-term costs to Kansans, especially for minority groups.  

Metzl attacks the “Castle Doctrine” (“a man’s home is…”) as a symbol of narcissism, individualism, and as a risk for all citizens when social structures are abandoned. He closes with some hopeful examples of social change for the better.

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Go Set A Watchman

Lee, Harper

Last Updated: Apr-25-2019
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Now 26 years old, Scout (Jeanne Louise) returns home to Maycomb, Alabama, where she encounters many changes. Her brother has died. Her heroic father, Atticus Finch, who defended the wrongly accused man in the earlier acclaimed novel (To Kill a Mockingbird) is still carrying on his legal practice and his role as a wise pillar of the community, despite his advancing age. He is approached to defend a black man who has killed a white man in a motor vehicle accident.

Scout renews contact with old friends, including Hank who still hopes that she will marry him. The old places spark memories told in 
deftly written flashbacks that beautifully evoke the atmosphere of a small southern town in the heat of summer. Some flashbacks– an imagined pregnancy following a chaste kiss and an escapade with falsies at a school dance-- are hilarious renditions of ‘tweenage’ angst, typical of any time or place.

But Scout is disgusted by the social spying, the rumors that easily build, and the latent racial hatred that lurks everywhere. The memories of her “color-blind” childhood make her confrontation with the cruel, racial tensions in the more recent time all the more upsetting. Even her beloved nanny, Calpurnia, is now alienated with distrust and repressed anger. The climax comes when she witnesses her father, as chair of a meeting, give the floor to a notorious racist. Scout confronts him and he launches into a long self-justifying and not entirely convincing defense of the need for free speech. The disquieting conclusion is ambiguous. 
 

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The Slap

Tsiolkas, Christos

Last Updated: Mar-12-2019
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

In Melbourne, Australia, Hector and Aisha are hosting a big barbecue for their families and friends who come with several children. Hector’s somewhat controlling Greek parents appear too, bringing along too much food and their chronic disapproval of his non-Greek wife despite the two healthy grandkids and her success as a veterinarian. Aisha’s less-well-off friends, Rosie and Gary, arrive with their cherubic-looking son, Hugo, who at age three, is still breastfed and being raised according to a hippie parenting style that manages to be both sheltering and permissive. Hugo has a meltdown over a cricket game, which the older kids have let him join.  He raises a bat to strike another child, when Hector’s cousin, Harry, intervenes to protect his own son. Hugo kicks Harry who slaps him. Rosie and Gary call it child abuse and notify the police. 

The aftermath of the slap is told in several fulsome chapters, each devoted to a different individual’s perspective: among them, Hector, Aisha, Harry, Rosie, Hector’s father, and the teenaged babysitter Connie. Harry is rendered miserable by Rosie and Gary’s aggressive lawsuit against him. Connie believes she is in love with a philandering, substance-abusing Hector who in turn has unscrupulously led her on. Recognizing its alienation of her friends, Rosie sticks to her legal pursuit of Harry although she worries about the drain on their meagre finances, the exposure of Gary's drinking, and the anticipated criticism of their parenting style. Aisha is fed up with her husband’s edginess and submission to his parents, and she flirts with escape in the form of a handsome stranger at a conference. 

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The Center Cannot Hold

Wells, Kenneth

Last Updated: Jul-31-2018
Annotated by:
Glass, Guy

Primary Category: Performing Arts / Theater

Genre: Theater

Summary:

This is an opera based on Elyn R. Saks’s best-selling book The Center Cannot Hold.  Subtitled “My Journey Through Madness,” the memoir recounts the author’s struggle with schizophrenia.  Here, Saks has collaborated with composer/psychiatrist Kenneth B. Wells on the opera’s libretto.  

The librettists utilize the device of having three different singers portray Elyn.  One manifestation, the “Lady of the Charts,” represents her when psychotic.  The others are Elyn as a law student and the present day Professor Saks as a law professor.  Another dramatic device involves the use of a chorus to embody the protagonist’s schizophrenic delusions.  At the height of her paranoia, as Elyn sings Beethoven’s 5th Symphony in an effort to keep herself together, the chorus recalls the Symphony’s opening notes by singing “Elyn must die.”  

The opera opens with Elyn as Professor Saks reflecting on her childhood. Even then there were signs of the illness that, to quote a famous poem by William Butler Yeats, ensures “the center cannot hold” in Elyn’s life. During the first act, Elyn, a Yale law student, becomes psychotic in front of her friends and is hospitalized. In a Connecticut hospital she is put in restraints and treated by various mental health professionals. She imagines she hears demons threatening to kill her.  Elyn’s diagnosis and condition overwhelm her parents, who have been called by the hospital.  

In the second act, Elyn works to reintegrate her fragmented mind.  She is determined to get back to law school.  She is released from the hospital. She finds an antipsychotic medication, with fewer side effects, that she can live with. She resolves to devote her career to mental health law.  At the conclusion of the opera, Elyn anticipates graduation.  She has been instrumental in winning a class action suit against the use of restraints in psychiatric patients.  Her parents, friends and doctors proclaim their pride in her accomplishments.

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Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

In 1869 in the remote northern Scottish village of Culduie, teenager Roderick (Roddy) Macrae brutally murders his neighbor, Lachlan “Broad’ Mackenzie, and two others. He readily admits to his crime, motivated, he says, by a desire to end the dreadful vendetta that Broad waged against his widowed father. The sympathetic defence lawyer, Andrew Simpson, urges him to write an account of the events leading up to the tragedy.  

Roddy agrees. In a surprisingly articulate essay, the young crofter describes his motive, originating with his birth and escalating through the lad’s mercy killing of an injured sheep belonging to Broad (interpreted as wanton), Broad’s sexual torment of his sister and mother, and his abuse of power as a constable that strips the family of land, crops, and finally their home.  

Given Roddy’s passivity, intelligence, and previously clean record, Simpson prepares a defence of temporary insanity and brings two physicians to assess his client, one a purported expert in the new field of medical criminology.  
 

The jury trial proceeds with an almost verbatim transcript derived from newspaper sources. The reader is able to juxtapose Roderick’s account with that presented in court. To report the outcome here would reveal too much.

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Sutton's Law

Wright, Linda; Orient, Jane

Last Updated: Jan-05-2018
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Intern, Maggie Altman, begins her postgraduate training in a large Texas hospital where a new computerized system has been implemented to improve service. She pours heart and soul into her work, but her admissions always seem to be the sickest patients who keep dying, sometimes inexplicably. Maggie becomes suspicious of her colleagues and of Dr. Milton Silber, an irrascible, retired clinician with no fondness for the new technology. Silber also happens to be a financial genius. Overhearing conversations and finding puzzling papers, Maggie imagines a scam, in which her supervisors may be eliminating dying patients to reduce costs, improve statistics, and siphon funds to their own pockets.

The bad outcomes for Maggie's patients are noticed and criticized, and she is pressured to drop out, switch hospitals, or go back into research. She senses that the perpetrators are aware of her suspicions and send her the worst patients in an effort to eliminate her. She trusts no one. These worries are compounded by her own illness and her accidental discovery in the morgue of a traffic in unclaimed bodies. With the help of excellent clinical skills, true friends, Dr. Silber, and a new love interest who is a budding financial genius, she survives physical and emotional violence and solves the mystery of patient homicides, poisonings, and fraud.

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The Children Act

McEwan, Ian

Last Updated: Jan-05-2018
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Approaching age 60 and childless, Fiona Maye is a family court judge who must decide if 17 year-old Adam has the right to refuse blood transfusions for his leukemia. He and his parents are Jehovah’s Witnesses.  The Children Act does not allow a child to make this decision until age 18. Fiona is an atheist and her 35-year marriage to an academic is falling apart.  She takes the extraordinary step of visiting Adam to know him and understand his conviction. He is beautiful and gifted, he writes poetry and plays violin. Why would he not want to try to live? She makes her decision having no idea if it will be morally, legally or medically right. To say more would spoil it.

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The Anatomist's Apprentice

Harris, Tessa

Last Updated: Jan-05-2018
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

In 1780, Thomas Silkstone, a young American surgeon and anatomist, is invited by Lydia to establish the cause of death of her brother, Lord Crick, a dissolute who held the Oxfordshire estate that she will inherit. Her goal is to absolve her husband of the suspicion of murder; however, as the investigation proceeds, it increasingly seems that her husband is guilty after all.

 The earnest young doctor methodically examines each new lead—performing experiments on tissues and with various poisons in his effort to determine the cause of death – and in so doing solve a murder. Before long, another person is dead and Thomas is in love with Lydia, a scarcely concealed complication that calls his testimony into question.

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