Showing 1 - 10 of 1350 annotations tagged with the keyword "Death and Dying"

Annotated by:
Teagarden, J. Russell

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Dr. Ross Slotten chose family medicine to serve patients from cradle to grave. But, as he was entering practice, the AIDS virus was entering the community where his practice was situated, and he found himself serving patients much closer to the grave than the cradle. 

In June 1981, a few weeks before I began my internship in family practice at [St. Joseph Hospital in Chicago], the Center for Disease Control in Atlanta had published the first report of a strange lethal infection among a cohort of gay men in Los Angeles. I had no clue then that the disease would soon kill friends, former lovers, colleagues, and patients; devastate tens of millions of people and their families worldwide; and consume my entire professional life and more than half my chronological one. (p.14)

From both the circumstance of time and place he found himself in, and the sense of necessity and compassion that claimed him, Slotten’s professional trajectory unexpectedly shifted away from traditional family medicine towards specializing in AIDS. His interest in AIDS, however, extended to personal considerations, because as a gay man, he was part of the population at risk, and harbored the same anxieties and fears he saw in his patients and throughout his social circles. His patients were principally gay men because of his geographic location in an established gay community and the resulting referral patterns. The book chronicles both his experiences as a physician at Ground Zero taking care of gay men with AIDS, and his experiences as a gay man at risk for AIDS. For Slotten, these experiences were not independent of one another, which makes for rich insights on the complexities of both. 

Slotten spent a lot of time at St. Joseph Hospital because his patients required intense medical support and specialized services. He tells how he and his practice partner pushed for establishing a specialized AIDS unit in the hospital. They bumped up against the usual bureaucratic obstacles, plus a few more concerning issues specific to AIDS patients, but they ultimately prevailed. Slotten “was to spend the next fifteen years there, often heartbroken, occasionally inspired” (p. 109). In contrast, Slotten recounts how some specialists he called for help with particular patients would not avail themselves to AIDS patients. Those occurrences stuck with him: “I couldn’t forgive those other physicians for abandoning me and my patients in the hours of our greatest need” (p. 108). 

A blending of wanderlust, intellectual curiosity, and an urge to understand “the AIDS epidemic as a public health problem, not just a medical condition” (p. 154), motivated Slotten’s pursuit of formal postgraduate education in public health. He supplemented this education with a trip to Namibia, and reports the observations he made there, among them how “an epidemic like AIDS would be unstoppable” (p. 165), given the factors he saw at work then.

With whatever little time he had left for volunteer and advocacy work, Slotten stayed local. He talks about the volunteer-run health clinics where he worked, and the housing facility he helped set up for homeless people with AIDS. He left protesting at the Food and Drug Administration, the National Institutes of Health, and the annual International AIDS Conference to others while he focused on his patients, his studies, his volunteer work, and his own safety.

The decade of the 2020s is approaching when Slotten writes about the preceding three-and-a-half decades. As he finishes the book he is still caring for people with HIV, but the horrible complications of AIDS are now infrequent since the availability of effective medications. His practice had been reliably stable and predictable for some time, a circumstance he could only dream of when he first started. Alas, that dream had ended by the time the book was released on July 15, 2020, when Covid was surging.

View full annotation

The Hours

McDermott, Phelim

Last Updated: Feb-13-2023
Annotated by:
Brungardt, Gerard

Primary Category: Performing Arts / Theater

Genre: 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

Grief

Barrett Browning, Elizabeth

Last Updated: Jan-24-2023
Annotated by:
Ratzan, Richard M.

Primary Category: Literature / Poetry

Genre: Poem

Summary:

Published in 1844, "Grief" is one of several sonnets Elizabeth Barrett Browning (EBB), the oldest of twelve children, wrote following the death of her 33 year old beloved brother and immediately younger sibling, Edward (nicknamed "Bro"), by drowning in 1840. (Another brother, Samuel, had also died, 5 months earlier at age 28, in Cinnamon Hill, the family's estate in Jamaica, from a fever.) The other sonnets reflecting the numbing grief EBB felt (as expressed in her letters) after Bro's death are "Tears" and "Substitution". All were published in her 1844 Poems.

"Grief" is a Petrarchan sonnet describing the distinction between the poet's "hopeless grief" and the grief of men "incredulous of despair". She further instructs "deep-hearted man" to adopt the poet's form of grief, to "express/Grief for thy Dead in silence like to death". This "silence like to death" reflects EBB's movement to speechlessness and silence following Bro's death. (ref = Billone)



View full annotation

Demon Copperhead

Kingsolver, Barbara

Last Updated: Jan-24-2023
Annotated by:
Teagarden, J. Russell

Primary Category: Literature / Fiction

Genre: Novel

Summary:

This novel recasts Charles Dickens’ David Copperfield for modern day as a literary take on the opioid addiction crisis in the U.S. during the 1990s and 2000s with apparent connections to Beth Macy’s nonfiction book, Dopesick, and the eight-part TV miniseries of the same name it spawned. The author, Barbara Kingsolver, assures potential readers that having read David Copperfield is not a prerequisite for comprehending and appreciating Demon Copperhead.   

Demon Copperfield, a name that evolved naturally enough in early childhood from his birth name, Damon Fields, was born into entrenched poverty in the heart of Appalachia, Lee County, Virginia. He tells his story starting from when he drops out of his drug-addicted mother’s womb onto the floor of a rented trailer, to when as a young adult, he makes a last-chance effort at breaking loose from the life-threatening clutches of Lee County. In between, his stepfather frequently beats him bloody, his mother dies from a drug overdose, he enters foster care, attends school off and on, and works assorted jobs, many of which involve illegal, unethical, and dangerous activities. All the while he is variously abused, starved, and exploited. 
 

Demon shares his plight with many others in the community, and though they help each other as best they can, nearly all of them become ensnared in the same traps—drug addiction, alcoholism, unemployment, hazardous occupations, unfinished education, familial disintegration, and societal abandonment. For Demon, these conditions and experiences obliterated any vision of a future free of entrapments, let alone one of prosperity and happiness. “Here, all we can ever be is everything we’ve been. I came from a junkie mom and foster care,” is how he assessed his prospects (p. 461). 
 

Amidst all this suffering and bleakness, an observant and caring teacher discovers Demon’s talent in graphic arts, and he gets a peek at a path to commercial success. He has to first fight off what he knows of “Lee County being a place where you keep on living the life you were assigned” (p. 460). His story turns to this fight and onto this path. 

View full annotation

Sinkhole

Patterson, Juliet

Last Updated: Jan-18-2023
Annotated by:
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

Summary:

Anna Gasperini builds on existing scholarship by examining how Victorian ‘penny blood’ literature depicted working-class readers’ anxieties concerning medical dissection following the 1832 Anatomy Act. Within the historical context of Britain, a dearth of cadavers spurred the rise of various crimes, including body-snatching, graverobbing, and murder. While the families of the middle- and upper-class dead could finance a funeral and secure a place of safe rest, such as in an ancestral vault or tomb, the poor were often buried in shallow or mass graves. These burial sites were often unearthed, and the bodies were sold to (knowing and unknowing) medical men for anatomical examination. To quell these crimes, government authorities instated the 1832 Anatomy Act, which was “a law that allowed anatomists to source dissection material from the pauper” (xii). More specifically, Gasperini explains, “[w]hen it was passed, the Anatomy Act imposed that the bodies of those who were too poor, or whose families were too poor, to afford a funeral were to be handed over to the anatomy schools for dissection” (xii). The Anatomy Act, disregarding pauper consent and personal wishes, effectively targeted impoverished people who relied on workhouse support and alms, exploiting poor bodies to supply medical schools and advance research. The fear and disgust for the law were widespread: “. . . for them [working-class penny blood readers] dissection, bodysnatching, and forfeiture of one’s body to the anatomists after 48 hours under the Anatomy Act were a terrifying reality” (xiii). This fear oddly presaged Count Dracula’s remark in Tod Browning’s 1931 film: “There are far worse things awaiting man than death.” In other words, the finality of death may be incomprehensible, but posthumous desecration of the body through dissection provokes a deeper sense of horror.

Exacerbating the act’s legal conditions was the fact that “semi-literate” working-class people, although vaguely aware of the law’s significance, could not fully interpret the dense legal argot that described the new regulations—an example of cruel political skullduggery—which obscured what would happen to their bodies following death (12–13). Far from being a benevolent political gesture, the act “. . . was an exercise in rhetoric, against which the pauper—semi-literate, socially powerless, and politically underrepresented—could not possibly win” (15). Popular fears that predated and intensified following the act concretized suspicion and anger directed at physicians, the medical sciences, and mortuary practices.

These apprehensions, Gasperini argues, found vivid expression in the pages of the penny blood, a genre “churned out by underpaid hack-writers” and obsessed with storylines “involving murder, betrayal, gender-shifting, and the occasional supernatural event (not to mention scantily clad damsels in distress)” (4). While the penny blood’s serialized melodramas were derided as tawdry sensationalism by middle- and upper-class readers, the genre reflected working-class preoccupations about the Anatomy Act and how the bodies of the impoverished dead were subject to the posthumous medical gaze (4). The penny blood embraced a “generally more violent and graphic concept of entertainment that was popular among lower class individuals. . . .” (4) and constructed plots that directly tapped into long-entrenched suspicions about medical cruelty and physical dismemberment. While the era’s educated readership disdained the recognizable tropes of the penny blood—murderous graverobbers, devious surgeons, vampires, eldritch cemeteries, and cadavers—the narratives in which they figured elucidated the virulent classism and exploitation perpetuated by the Anatomy Act. 

Gasperini provides close readings of a range of penny blood texts, including Manuscripts from the Diary of a Physician (1840s), Varney the Vampyre; or: the Feast of Blood (1840s), The String of Pearls (1840s, popularly referred to as Sweeny Todd, The Demon-Barber of Fleet Street), and The Mysteries of London (1840s). Not all narratives have explicitly medical themes or characters who are physicians or anatomists, nor do the stories make overt reference to the Anatomy Act. Instead, as Gasperini’s analyses demonstrate, they all confront larger working-class anxieties concerning mortality and what might be regarded as the social afterlife of a human corpse, whether that be posthumous dissection, cannibalism, necrophagy, or some other horrific desecration of the body. Fundamentally, while the stories vary, they share a general preoccupation with the corpse’s “bodily integrity” (16), asking what forces act upon the body (or have the authority to) following death and expressing fear over the individuals and institutions that presume to disturb the repose of the dead. Indeed, for all the penny blood’s grotesquery, there is a tacit insistence on the sanctity of the corpse; however, as Gasperini illustrates, the genre does not flinch from revealing the grim consequences of disturbing this repose in the interests of greed and medical progress.

View full annotation

Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Through ten short chapters, family doctor Susan Boron explains the origin of her neologism, “tokothanatology,” the study of common practices that surround both birth and death, events that “bookend” our existence. Daughter of an obstetrician who pioneered family-centered birth and spouse of a man who worked in palliative care, Boron noticed the tremendous similarities in the gestures, rituals, and obligations of dealing with both the beginning and the end of life. The obligations extend to the loved ones in the sphere of patients in care--a practice, she writes, “from pre-cradle to post-grave.” 

One chapter reviews the rituals emerging from many different cultures and religions; another examines portrayals of birthing and dying in image and word; yet another addresses the impact of sudden and unanticipated outcomes. Ethical and legal dilemmas and the contingencies imposed by time and place are discussed frankly.  

Recognizing the advantages of medical technologies, she is nevertheless skeptical of their utility in every case and includes practical advice for dealing with pain, showing that midwifery techniques could enhance palliation. Throughout, she acknowledges that things have changed, are changing, and will change again. Sources are referenced in footnotes. 

In the end, the repeated message is one we’ve heard many times before, offered in a refreshing way: the importance of empathy and of listening to the patient's wishes in birthing and in dying. 

View full annotation

Severance

Stiller, Ben

Last Updated: Nov-21-2022
Annotated by:
Brungardt, Gerard

Primary Category: Performing Arts / Film, TV, Video

Genre: TV Program

Summary:

The titular "severance" surgical procedure is the ultimate answer to the work-life balance conundrum - separating work consciousness from personal consciousness. The person's work-self has no memory or knowledge of their personal-self, and vice versa. Lumon Industries and its employees do this for seemingly good reasons (e.g. to assuage grief) but unanticipated and darker motives are in tension throughout the series as its nine episodes follow a core team of four office workers navigating the realities of having had this procedure done.

View full annotation

The Mouth Agape

Pialat, Maurice

Last Updated: Nov-07-2022
Annotated by:
Teagarden, J. Russell

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

“Can you take your mother home? There’s no point our keeping her here,” the doctor says to Phillipe about his mother, Monique. Her breast cancer has spread to her spine and probably her brain. Monique had been staying with Phillipe and his wife, Nathalie, in their cramped apartment in Paris during her treatment. They took her to her home in Auvergne, and there she remained, confined to her bed, until she died. 

Monique’s husband, Roger, cared for her while also managing the family retail clothing store beneath their apartment. He spoon-fed her, cleaned her, and tried to make her comfortable with the aid of visiting nurses. Phillipe and Nathalie came from Paris to help care for Monique and provide some relief for Roger. As Monique deteriorated, she required more and more of their attention, which was made all the more difficult when she lost her ability to speak. Fatigue set in and nerves frayed. Nevertheless, when Monique died, tears were shed, hugs were shared, and memories were recounted. 

Through it all, though, not one of three family members exhibited a bit of grace. As they had before Monique became ill, they lied to each other, cheated on each other, and stole from each other while caring for her. None were above physical abuse—“you slapped me for no reason,” Nathalie reminds Phillipe, Roger paws his female customers just below where Monique lies ill in her bed. Monique, no angel herself, had behaved similarly before cancer crimped her style. After the funeral, Roger returned to his store, and Phillipe and Nathalie to Paris, where they ostensibly would pick up where they left off with their lives of banal wantonness. 
 

View full annotation

Summary:

Physician-Assisted Suicide and Euthanasia, edited by Shelton Rubenfeld and Daniel Sulmasy, is an unusual collection of scholarly essays in that it combines essays about Nazi euthanasia with others that deal with contemporary PAD (Physician Aid in Dying) and questions whether there might be a relationship between the two. This perspective is understandable, given the book’s origin. The Center for Medicine after the Holocaust, an organization with the mission “to challenge doctors, nurses, and bioethicists to personally confront the medical ethics of the Holocaust and to apply that knowledge to contemporary practice and research,” invited a group of North American and Israeli palliative care specialists and medical ethicists in 2018 to visit German sites associated with Third Reich euthanasia programs.  The intensive discussions that followed resulted in this provocative collection of papers.  

Dr. Timothy Quill is among the writers supporting the moral probity and legalization of PAD, while Drs. Diane Meier and Daniel Sulmasy present strong arguments against the practice.

View full annotation