Showing 1 - 10 of 1019 annotations tagged with the keyword "Love"

Summary:

Mindy Thompson Fullilove, MD, is a Black social psychiatrist with wide-ranging interests; her book analyzes factors that support or diminish the health of cities as places that sustain its citizens. Over many years, she has visited and studied 178 cities in 14 countries, and she draws on the work of experts from several disciplines to address the fundamental question: how may we best live together?  

Her discussion moves through five concepts for understanding the health of a city by describing a dozen cities ranging from Paris to Jersey City. Each features a “Scroll,” a two-page presentation of photos, graphics, and text. Her discussions give an inductive basis for her concepts that become criteria for assessing the health of any city.     

(1) Box (“in all sizes and shapes”): the surrounding shape of buildings, street, and sky; it gives an identity to the city’s center with its useful assets such as stores, post office, bank, food, and entertainment.
(2) Circle: the larger area surrounding a Box—maybe a half a mile in radius. Its health requires ease of travel to and from the box.
(3) Line: usually the Main Street that runs through the box, therefore a central path to town. Good transportation is important, and the main street can be quite long, for example Palisades Avenue in Englewood, New Jersey.
(4) Tangle: a dense network of streets and highways that connect to main streets and the Box.
(5) Time: no city is static; as years go by, there are changes for good or ill.  

Fullilove mentions politics, capitalism, poverty, disincentives, tribalism, racism, highways, malls, interstates, and “urban renewal” that destroyed neighborhoods of minorities, as well as redlining against Blacks and gerrymandering school districts to segregate Black and white students. 

In “Naming and Framing the Problem,” she turns to a larger overview of challenges for cities in many places, but especially in the US:
(1) “deep structure of inequality” (p. 211), such as the legacies of slavery, lynching, the 3/5 Compromise, and the Trail of Tears, as well as white supremacy today (2) ecological damage, including industrial farming, deforestation, and global warming, and (3) the inertia of the status quo. 

Citing Dr. Martin Luther King, Jr., and Father Richard Rohr, Fullilove affirms love as the root  for social justice, political activism (p. 211) so that cities might become what Thomas Edison termed “factories of invention” that will support the mental health and well-being of all of its citizens. 
 

View full annotation

Summary:

In this collection of autobiographical essays, Koven contemplates some unique challenges confronting female physicians: discrimination, sexism, lower annual salary on average than male counterparts, possible pregnancy and motherhood. She recalls her medical school and residency experience, describes her internal medicine practice, and highlights her role as a daughter, spouse, and mother.

Worry is a theme that works its way into many phases of Koven's life and chapters of this book. The opening one, "Letter to a Young Female Physician," introduces self-doubt and concerns of inadequacy regarding her clinical competence. "Imposter syndrome" is the term she assigns to this fear of fraudulence (that she is pretending to be a genuine, qualified doctor). She worries about her elderly parents, her children, patients, and herself. Over time, she learns to cope with the insecurity that plagues both her professional and personal life.

Some of these essays are especially emotional. "We Have a Body" dwells on the difficult subject of dying, spotlighting a 27-year-old woman who is 27 weeks pregnant and diagnosed with adenocarcinoma of the lung. "Mom at Bedside, Appears Calm" chronicles the author's terror when her young son experiences grand mal seizures and undergoes multiple brain surgeries for the tumor causing them.

Listening emerges as the most important part of a doctor's job. Koven encourages all doctors to utilize their "own personal armamentarium" which might include gentleness, exemplary communication skills, a light sense of humor, or unwavering patience. She fully endorses a concept articulated by another physician-writer, Gavin Francis: "Medicine is an alliance of science and kindness" (p228).

View full annotation

Summary:

This is a quick and personal history of the Longwood Symphony Orchestra (LSO), a group of Boston area musicians who, in their working lives, are medical personnel. The first of its kind, there are now several such orchestras across the US and scattered throughout the world, notably in Europe. Lisa Wong, a pediatrician and violinist, tells her own history of medicine and music, including her involvement with the Longwood Symphony Orchestra over some 28 years. Other stories of individual doctor/musicians are threaded throughout the book, giving us a personal look at their interdisciplinary enterprise. While their medical specialties, ages, and backgrounds vary widely, while playing in the orchestra and, various professional ranks aside, they accept the direction of the conductor. While Wong mentions antecedents of medicine and music in ancient times, she chooses Dr. Albert Schweitzer as a patron saint for the LSO.

For Wong and her fellow doctors, there are links between music and healing. Music helps keep doctors (and patients) healthy by calming the heartbeat, relaxing muscles, and lifting the mind (p. 86). Music therapy (the psychotherapeutic use of music) and music medicine (the more general uses of music, often in medical settings) can assist in patient care. For example, a dementia patient named Ruth reawakened upon hearing music. Some patients choose to listen to music in the final days of their lives (p. 184).      

For many doctors, music was an early pursuit. Neurological studies suggest that musical training helps develop “structural brain plasticity” that may show benefits in education and training. By contrast, however, sometimes musicians (doctors or not) develop overuse injuries and need specific physical therapy.           

Music has applications in mental health, hospitals in general, and community partners. The LSO has partnered with some 40 nonprofits in the Boston area. In one example, they helped grow the Asian bone marrow registry from 3,000 to 11,000 people (p. 225). An LSO concert raised $30,000 for the Mattapan Community Health Center in South Boston.  

Lisa Wong was president of the organization for 20 years. She writes, “Music goes a long way to heal entire communities. Social justice and social welfare are important determinants of health. Programs that look beyond the music are truly ‘Healing the Community through Music’” (p. 249). 

View full annotation

Call Me by Your Name

Guadagnino, Luca

Last Updated: Sep-28-2020
Annotated by:
Brinker, Dustin

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

The story begins “somewhere in Northern Italy” in 1983 chez Perlman, a multicultural and well-educated family. Every summer, the family (Michael Stuhlbarg & Amira Casar) host a classical-arts graduate student for six weeks at their holiday home. Elio Perlman (Timothée Chalamet), the family’s 17-year-old precocious son, is expected to act as host and guide to the selected student, this year a 24-year-old American named Oliver (Armie Hammer). From the beginning, the two have a love-hate relationship; an unspoken emotional tension exists between them. Uncertain of how to handle this tension, Elio begins exploring his sexuality with his female friend, Marzia (Esther Garrel). He eventually, albeit obliquely, admits his feelings for Oliver, and the two begin a brief love affair during which Oliver suggests, in bed, that they call each other by the other’s name. Noticing the closeness of the young men, the Perlman parents suggest that Elio accompany Oliver as he spends a few days in Bergamo prior to leaving for the United States. The sojourn concludes with a bitter goodbye: Oliver departs by train, leaving Elio on the railway platform. Unable to complete his journey home alone, Elio makes a tearful call home for his mother to come pick him up. Back in town, Marzia, seeing a grief-stricken Elio, approaches and forgives him, insinuating that she knows about his recent tryst and that she will always be his loving friend. Months later, the Perlmans return to the town for Hanukkah. While his parents are in the process of picking next summer’s student, Elio gets a bittersweet surprise: Oliver is calling to inform the family that he is engaged, to a woman. The film concludes with Elio, grappling with a tumult of emotions, staring into the dining-room fireplace, the light flickering in his red, tear-sodden eyes.

View full annotation

Annotated by:
DiLeonardo, Olivia

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

Genre: Graphic Memoir

Summary:

Dr. Weaver-Hightower wrote, illustrated, and published this powerful graphic work in the Journal of Medical Humanities.  The comic itself is presented in a traditional paneled format, with a few exceptions, and rendered in a moody ink wash in black, white, and various shades of darker and lighter greys. The story is told in the authentic, sometimes faltering voice, of the father of Thomas and Ella, a pair of twin infants who died at 22 and 24 weeks into pregnancy. Beginning with their harrowing trip to the hospital, the comic describes the father and mother’s loss of Ella, shortly after she was born prematurely; their subsequent wait for Thomas to reach the “viable” age of 24 weeks; his stillbirth; and the couple’s sudden discharge from the hospital, going home with “empty arms”.  The story then transitions into “The Long After”, including the funeral and the phases of the parents’ grieving process.  The father describes his grief, frustrations, the couple’s differing ways of coping, and his ambivalence and anger toward religion as a source of comfort or deeper understanding.  On the last page, he recounts their hopes and fears as they enter into their second pregnancy, concluding with panels of the father wrestling with how to understand and process this loss.  The final panel is an image of the father in profile, expressionless, saying nothing, a fitting conclusion to a story for which words seem to fail. 

With this piece, the author introduces us to the genre of the “research comic”. The comic is followed by a methodological appendix, which explains the author’s process for choosing, capturing, and relating this history in words and illustrations, as well as his rationale for selecting a comic or graphic memoir format for the piece.  The author also elaborates upon the concept of the comic as a form of “rigorous, informative research” (226).  The appendix is very interesting and will satisfy the curiosity of readers asking the questions, “How did he do this?”, or “Why is this story a comic?”, but the piece stands on its own without the appendix, as well.  

View full annotation

Annotated by:
Donley, Carol

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

 Cortney Davis has divided this collection of her poetry into seven major sections which she calls “Voices.” The first and last sections are “Voices of Healing” which frame and wrap around the others: “Home,” “Desire,” “Suffering,” “Faith,” and “Letting Go and Holding On.” The sections include previously published poems as well as new ones.  Davis is known for her ability to see and understand what is going on and to express that in ways that help the reader “get it.”  This collection also shows her ability to hear the unique voices that express suffering, faith, desire—and to convey empathic understanding of the speaker.  Sometimes she gets angry with the speaker. The poems range through time, from her childhood, nursing training, nursing experiences, deaths of her parents, to more current experiences with grandchildren.  Throughout there is a consistent caring and compassion, mixed with many other feelings, many of them contradictory.

View full annotation

The Winter Soldier

Mason, Daniel

Last Updated: Jun-20-2020
Annotated by:
Field, Steven

Primary Category: Literature / Fiction

Genre: Novel

Summary:

When The Winter Soldier opens, Lucius Kszelewski, youngest son of a patrician Polish family living in Vienna, is on a train bound in the dead of winter for a field hospital in the Carpathian Mountains.  It is 1915, and Austria-Hungary is at war with Russia.  Lucius, a medical student, has completed only six semesters of medical school, but World War I has intervened, and due to a shortage of physicians in the army the government has decreed that students may graduate early, become doctors, and immediately be commissioned.   Lucius has done so and is on his way to Lemnowice, a Galician village, where he believes he will work with other physicians and finally learn to be “a real doctor.” 

When he arrives, he finds that the hospital is an expropriated village church overrun by rats and ravaged by typhus, and he is the only physician.  The hospital is run by a nun, Sister Margarete, assisted only by orderlies, and the patient load runs the gamut from fractures and gunshot wounds to gangrenous legs and massive head trauma.  The front is only a few kilometers away, and the wounded arrive continuously; the quiet and formal Sister Margarete confidently and  surreptitiously guides him through rounds, surgeries, and battlefield medicine.  Lucius is initially wary of her, perhaps a bit awed by her, and ultimately falls in love with her.    

The transforming event is the arrival of the winter soldier, Jozsef Horvath, brought in from the snow mute and shell-shocked, but with no visible wounds.  Lucius is fascinated by diseases of the brain and mind, and this patient presents a tremendous challenge.  Lucius is sure that Horvath has “war neurosis,” what the British physicians of the time were calling shell shock and what we today would call PTSD, and he is determined to understand and heal him.  Lucius and Margarete make slow progress with their patient, but his attempts to care for Horvath have unintended effects, and Lucius must then deal with the consequences of his actions.  

The war, and the hospital routine, go on.  One day, while Lucius and Margarete are relaxing in the woods, Lucius asks her to marry him.  Margarete runs off, and Lucius returns to the village, but Margarete is not there.  While Lucius and the staff search for her, Lucius gets lost; he stumbles onto a battlefield and is dragooned into service with a regiment of the Austrian infantry.  He escapes and tries to make his way back to the field hospital, and to Margarete, but Lemnowice has fallen to the Russians.  The hospital has been evacuated—and Margarete has disappeared.   Lucius’ search for her will take him across the war-torn remnant of the Empire.

View full annotation

Pain Studies

Olstein, Lisa

Last Updated: Jun-10-2020

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

“All pain is simple” reads the opening sentence of this unusual and striking book. The next sentence reads, “And all pain is complex.” These two sentences foreshadow many puzzles to come: how do we live between chaos and control? Why can’t doctors figure migraines out? Why don’t they agree on a treatment for a particular patient? Olstein is a poet and long-term migraine sufferer. Her book offers many observations about pain, and her attempts to define it, describe it, and plumb its nature through language. There is no linear narrative or argument, rather 38 very brief chapters—usually three to five pages—and many of these could be read in a different order. 

Olstein uses the terms “studies” and “research” for her efforts to capture pain, to explain it, and to understand the cause(s) of her disease. Her mother had migraines; women have three times the rate of men; she had a childhood head injury. Do any of these factors explain her disease? No. And what treatments work? She lists some 50 drugs/supplements/activities she has tried to deal with her illness. None of these have worked in a definitive way. Further, she lists some 30 side-effects she has experienced from these various treatments (pp. 74-75). She has had multiple migraines, one lasting three months, but she also says drugs keep pain at bay: “mostly the medication does work” (p 90).

Some disparate figures help her focus her inquiry: Joan of Arc (possibly a migraine sufferer), the TV character Dr. Gregory House (racked with chronic pain, he is an opioid addict), Virginia Woolf, and Hildegard of Bingen (possibly a migraine sufferer). Also ancient writers such as Lucretius, Pliny the Elder, and Antiphon the Sophist, and contemporaries from different fields, such as mathematics and neurology. Also she refers to poems by Emily Dickinson, Elizabeth Bishop, and C. D. Wright, as well as to an article on gendered literature by Siri Hustvedt. 

Largely written during a writing residency, these are incisive notes plus associations as she plumbs not only her illness but also her responses—as poet, as thinker, as searcher for healing—to the bizarre, long, difficult path of her migraines. (We have only brief mentions of her personal and family life.) While she refers to some scientific literature, it is more often that her insights come from artistic fields such a literature, sculpture, drama, and popular music. She writes that her work with a therapist over a dozen years has been helpful to her.

There is no conclusion…nor can there be. Her illness, treatment, and writing are all works in progress. Patients are different; doctors are different; science evolves. In their many forms and presentations, migraines are mysterious and complex, as this book creatively and powerfully shows. Olstein writes, “The beauty, the love, is in what we perceive” (p. 144). We may take this observation as the guiding principle for the book.   

View full annotation

Annotated by:
Galbo, Sebastian

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

Genre: Criticism

Summary:

In Death is But a Dream, Christopher Kerr, MD, PhD, the Chief Executive Officer and Chief Medical Officer of Hospice & Palliative Care Buffalo, shares his patients’ end-of-life dreams and visions. The content and intensity of these dreams vary, but often center on patients’ transient meetings with predeceased loved ones, offering a deeply spiritual sense of peace during periods of physical suffering. 

Using patient interviews, Kerr’s book does not fetishize dream events as ghostly commotions or in terms of pseudo-mysticism, or insist on using a religious framework for their interpretation, explaining rather that bearing witness to and legitimizing end-of-life dream experiences constitute a new ethical imperative in the practice of palliative care: “A true holistic approach to patient care must also honor and facilitate patients’ subjective experiences and allow them to transform the dying process from a story of mere physical decline to one of spiritual ascension” (Kerr 28). Case after case, his research documents that because end-of-life dreams provide patients with a singular emotional and psychological comfort that no palliative medication can simulate, hospice professionals need to validate patient dreams by listening carefully and compassionately. 

With this in mind, end-of-life dreams serve as a kind of counter-narrative to dominant cultural understandings and representations of human experiences in hospice, specifically stereotypes of terminally ill individuals as being incapable of meaningful communication, creativity, and understanding. Kerr’s patients’ narratives reveal that end-of-life dreams and visions are not trauma-inducing experiences or instances of religious prophecy, but “help reframe dying in a way that is not about last words and lost love but about strengthened selves and unbreakable bonds across lives” (142). 

Death is But a Dream 
upends medical research, or certain “limitations of science,” that oversimplifies end-of-life dreams by attributing them to neurological deterioration, oxygen deprivation, and the side effects of pain management medication (11). The general lack of rigorous, serious-minded research in end-of-life dream experiences is inseparable, in part, from institutionalized medicine’s “inability to see dying as anything but a failure” which has produced a healthcare system that “reflects a limited view of the totality of the dying experience” (7). The patient accounts that Kerr documents, however, reveal an undeniable dimension of human experience at life’s end whose complexities may be well beyond the reaches of full scientific understanding. End-of-life dreams seem to be part of an elaborate system of compensation (to borrow a term used by Siddhartha Mukherjee), as the mind works overtime to activate and animate certain memories to diminish the physical realities of dying. “There is an adaptation—substantive, spiritual yet cognitively meaningful,” writes Kerr, “a mechanism through which the patient can emerge from the dying process with a positive psychological change” (69). Indeed, the mystery of end-of-life dreams—their visions of loved ones; of seeking forgiveness, healing, and understanding within weeks, sometimes days, of one’s death; of comforting apparitions and visitations—points to a miraculous capacity within the human heart that eases the life-to-death transition.

View full annotation

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.

View full annotation