Showing 1 - 10 of 303 annotations tagged with the keyword "Surgery"

The Steel Windpipe

Bulgakov, Mikhail

Last Updated: Jun-02-2022
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

A little girl is brought to the rural hospital by her mother, who throws herself at the feet of the young doctor, “Please do something to save my daughter!” It seems that she has been suffering from a sore throat and is now having difficulty breathing. The doctor looks into her throat; diphtheria is evident.At first he scolds the mother for not having brought the girl earlier. Then he suggests surgery: a tracheotomy. The doctor knows this is the only way he might save the child, but he is consumed by anxiety because he has never performed the procedure. At first the mother objects to surgery, but then relents. The tracheotomy is successful and the child survives.

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Nervous System

Meruane, Lina

Last Updated: Dec-13-2021
Annotated by:
Teagarden, J. Russell

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Ella needs time for finishing her doctoral dissertation on black holes she has been writing for years and thinks an illness could provide the time: “Just enough to take one semester off, to not have to teach all those planetary sciences classes to so many distracted students whom she had to instruct evaluate forget immediately (p. 6). Before she can decide which illness would best suit her purposes, a mysterious illness finds her.
 A sudden cramp shoots down the spine and then, stillness... (p. 9)
An unbearable stinging had settled into her shoulder neck ember... (p. 10)
She felt an invisible wound wrapping her up and suffocating her... (p.10)
A slight numbness that starts in the shoulder and extends along the arm to the elbow until it reaches the back of her right hand, the fingers where it all started. (p. 12)
Inflammatio. In flames. En llamas. Ardor without romance. (p. 10)
Quickly, then, the story shifts from Ella’s dissertation odyssey to her diagnostic odyssey. As she makes her way along this journey during the first chapter, other characters come into the picture: El, Ella’s long-term boyfriend and forensic scientist, is one. The others in her family history are “the Father,” “the Mother,” “the Brother,” and “the Twins”—none are ever named (neither, really, is Ella or El because they are “she” and “he,” respectively in Spanish). Except for the Twins, each of the subsequent four chapters center on one of these characters and how they figure into the family history. Just as in the first chapter, the stories are told through and around the health challenges each character faced; all harrowing, many life-threatening, and some metaphorical.

Ever present in these histories is the story of Ella’s birth mother,“genetic Mother”. She died giving birth to Ella. Ella’s stepmother, “the Mother,” is called at different times, “the volunteer Mother,” “the replacement Mother,” and “the living Mother.” The Brother, alternatively known as “the Firstborn,” shares with Ella her birth mother and was born nine years before her. The Twins, known separately as “the Boy Twin” and “the Girl Twin,” came after the Father remarried. Another dimension shaping the stories is both the Father and the replacement Mother work as practicing physicians. 

Ella’s prominence in each chapter makes her our witness to El’s recovery after an explosion rips through his mass grave excavation site, and his many surgeries for separate gastrointestinal troubles; the Mother’s aggressive and brutal breast cancer treatment; the Firstborn’s recurring bone fractures (an “osseous enigma”); and the Father’s bleeding ulcers and life-threatening hemorrhagic complications from prostate surgery. 

The author, Lina Meruane, structured the book in a somewhat unconventional form. She delineates sections within each chapter with asterisks centered on the page (“***”), and these sections rarely comprise more than two paragraphs. Dialog is neither separated from other text nor signaled with quotation marks. The text moves back in forth in time, from here to there in place (presumably somewhere in South America), and sometimes takes the form of pensées rather than plot narrative. But, overall, the book moves towards resolving some mysteries surrounding family history.

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Born to Be

Cypriano, Tania

Last Updated: Feb-26-2021
Annotated by:
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. 

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Annotated by:
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).

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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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Summary:

Richard Holmes refers to this book as his “account of the second scientific revolution, which swept through Britain at the end of the eighteenth century, and produced a new vision which has rightly been called Romantic science” (p. xv). He pins the first scientific revolution to the seventeenth century and centers it on the work of Newton, Hooke, Locke, and Descartes. He brackets the second around 1768, when James Cook began his voyage circumnavigating the world, and 1831, when Charles Darwin began his voyage to the Galapagos islands. Holmes calls this period “The Age of Wonder.” 

Cook’s voyage carried Joseph Banks among its crew. Banks, a young man of great wealth and privilege, joined the expedition as a botanist to assist in the collection of botanical and zoological specimens from stops in the southern hemisphere. He was successful in this endeavor, and made observations about island life along the way (especially while on Tahiti). A few years after his return, he became the president of the Royal Society and would remain so for the next forty–two years.

The Society offered scientists (known then as “natural philosophers”) a place to publish papers, present findings, gain notoriety, receive funding, and develop networks. In his role as President, Banks was connected to many of the scientists included in the book. 

William Herschel and Humphrey Davy are the most prominent figures Holmes covers. Herschel was an accomplished musician and amateur astronomer before he built telescopes that helped him see, characterize, and record heavenly bodies never seen before. While conventional thinking of the time considered the universe to be static, placed by a divine hand, Herschel viewed it as continually evolving. Holmes also gives Herschel’s sister, Caroline, her just due as first his assistant and then as a noted astronomer in her own right.

Holmes focuses on Davy’s more well-known advances in chemistry: finding new elements; analyzing human effects of gasses comprising “common air” and “factitious airs” (e.g., nitrous oxide); inventing a safety lamp for miners; and applying the voltaic battery to chemical analysis. Holmes also details Davy’s role as a popularizer of science through well-received public lectures.

Aside from a chapter on Mungo Park’s ill-fated expedition to Africa, the other chapters have less focus on individuals and more on notable events. One concerns the first flights of hot air balloons, and another on the speculations of electricity as a life force that led to Mary Shelly’s novel, Frankenstein; Or, The Modern Prometheus. The final two chapters are in the service of Holmes’s view that “Science is truly a relay race, with each discovery handed on to the next generation” (p.468). He identifies the next generation of scientists and pays particular attention to William Herschel’s son, John, and to Davy’s protégé, Michael Faraday. Both went on to accomplished and celebrated careers. 

Holmes embeds the historical scientific developments and legendary figures into the ordinary daily life and human follies of the time. He describes how scientists and explorers sought public and private funding, and how they collaborated with one other on some occasions and competed with one another on others. We read of court intrigues, societal jostling, courtships and marriages, extramarital affairs (chaste and tawdry), and family relationships (devoted and fractious).  

A broader context Holmes provides involves the interplay among the scientists and explorers he covers and some of the important figures in literature, poetry, and art of Romantic era. Samuel Coleridge, William Cowper, John Keats, Mary Shelley, Percy Bysshe Shelley, Robert Southey, and Joseph Wright of Derby among others make appearances in the stories Holmes tells. He details the friendships between them and the influences they had on each other.

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Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Mallory Smith died of complications following a double-lung transplant for cystic fibrosis (CF). She was twenty-five years old and kept an extensive journal on her computer for 10 years. Salt in My Soul: An Unfinished Life is her memoir, edited by her mother, Diane Shader Smith, from the 2,500 pages of notes, observations and reflections which Mallory Smith wrote. The title refers to the intimate relationship of salt imbalance in cystic fibrosis, and the fact that Mallory felt her most well while swimming in the sea. Diagnosed at age three, she spent much of her days and nights treating the disease with medication, nutrition, chest percussive treatments, breathing treatments, adequate sleep, and aggressive treatment of infections. Unfortunately, while still a child her lungs were colonized with B. cepacia, a resistant bacteria ‘superbug’ which makes transplantation highly risky and hence leads to most centers to not accept CF patients onto their wait lists. Ultimately, University of Pittsburgh does accept Mallory as a transplant candidate, although her health insurance puts up every road block possible to her receiving care. 

Mallory Smith was extraordinarily accomplished – she graduated from Stanford University Phi Beta Kappa, and became an editor and freelance writer. She was also deeply engaged with life and others; she was grateful for her loving, devoted family, and she developed close, fierce friendships within the CF community, among classmates, and eventually, she fell in love. 

She resists being called ‘an inspiration.’ She writes: “I’m not an inspiration. I’m just a person, grounded in compassion, striving to achieve empathy and wanting to make my way with goodness and grace.” (p. 171) She marvels at the miracle of life: “Our existence is the result of stars exploding, solar systems forming. Our Earth having an environment hospitable to life, and then, finally, millions of highly improvable events accumulating over millions of years to bring us, a capable and conscious bag of stardust, to the here and now.” (p 111) Her memoir is a story of living and dying from CF, but it is also an inside look at the brief life of young gifted writer.

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Annotated by:
Kohn, Martin

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

About 20 Years ago, Linda Clarke, writer, professional storyteller and bioethics consultant was a neurosurgery patient of a colleague, Michael Cusimano at St. Michael's hospital in Toronto Canada. What was a distant relationship turned into one that was much closer. 10 years ago, Linda and Michael had a dialogue about recounting the story of her surgery and their relationship together. Linda became the "architect" of their project-- and they became co-authors in 2019 of In Two Voices: A Patient and a Neurosurgeon Tell their Story. The result is a lyrical co-memoir-- at times riveting, at other times sobering of their shared experience. What is probed goes much deeper than the facts, exposing the actors involved, their lives outside of their callings, their upbringing, and, most importantly, their differing interpretations of an important event during the surgery that only came to full light during the writing process. 

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Annotated by:
Teagarden, J. Russell

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Maggie O’Farrell describes the book in a scene involving a casual conversation she has with her mother over tea.

As she lifts the pot to the table, she asks me what I’m working on at the moment, and, as I swallow my water, I tell her I’m trying to write a life, told only through near death experiences. She is silent for a moment, readjusting cosy, milk jug, cup handles. ‘Is it your life?’ she asks. ‘Yes,’ I say, a touch nervously. I have no idea how she’ll feel about this. ‘It’s not…it’s just…snatches of a life. A string of moments. Some chapters will be long. Others might be really short.’ (pp. 142-143)
This conversation is the only place in the book where O’Farrell describes her intentions in writing it. But, what O’Farrell describes to her mother is exactly what the book is, a memoir comprising seventeen “brushes with death,” as she calls these moments. There is no prologue, there are no interludes, there is no coda, just the seventeen stories.

Few people will experience any one of these events, and perhaps only O’Farrell has experienced all of the events she tells us about. She categorizes them based on the anatomy involved in a particular brush with death. For example, some of the chapter names are: “Lungs” (three times), “Neck” (twice), “Abdomen,” “Intestines,” “Cerebellum,” “Circulatory System,” “Whole Body.” The one exception is the chapter, “Daughter.”

Other ways of categorizing the near-death experiences O’Farrell covers could be based on whether they threatened O’Farrell herself or any of her children, whether they were the result of bad luck (e.g., illness) or bad judgment (e.g., near drowning), or whether the threat originated outside the body (e.g., accident) or within the body (e.g., illness, medical procedures). The brushes with death from outside the body involved violence (twice), decapitation (twice), drowning (three times), a plunging commercial airliner, and a knife throwing exhibition. From within her body, close calls involved encephalitis as a child, amoebic dysentery while traveling in a developing country, a Cesarean section gone awry, and a few missed miscarriages (i.e., when fetus dies but no signs or symptoms manifest and surgical procedures become necessary). A daughter was born with severe allergic conditions that caused the child misery pretty much all the time interspersed with episodes of life-threatening reactions. O’Farrell’s son was almost lost in one of her near drownings.

O’Farrell leaves it to the epigraph she placed at the beginning of the book to stitch together how these stories collectively reveal the possibility of the human spirit to get us through the most serious and persistent challenges to our being. For this epigraph, she takes a line from Sylvia Plath’s novel, The Bell Jar:

I took a deep breath and listened to the old brag of my heart. I am, I am, I am.

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Annotated by:
Miksanek, Tony

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

After a combined twelve years of medical training and working on hospital wards, this British physician leaves the medical profession. Using his diary written during a stint in the National Health Service (NHS) from 2004-2010, he recalls his experiences as a young doctor.

He describes the making of a doctor and a physician's life as "a difficult job in terms of hours, energy, and emotion" (p196) and recounts the overwhelming exhaustion and toll on his personal life. He chooses OB/GYN as his specialty partly because "I liked that in obstetrics you end up with twice the number of patients you started with, which is an unusually good batting average compared to other specialties" (p32). As for his bedside manner, "I went for a 'straight to the point' vibe - no nonsense, no small talk, let's deal with the matter in hand, a bit of sarcasm thrown into the mix" (p163).

Days are filled with doing prenatal visits, vaginal deliveries, caesarean sections, gynecologic surgeries, and lots of women's health issues. Night shifts are often hellacious as they "made Dante look like Disney" (p5). He must handle emergencies, break bad news, deal with intra-uterine deaths, and once gets sued for medical negligence. The anecdotes are sometimes tender and heart-tugging, other times wacky and gross. Consider this diary entry dated 12 March 2007: "a lump of placenta flew into my mouth during a manual removal and I had to go to occupational health about it" (p92).

The final diary entry chronicles a catastrophe. An undiagnosed placenta previa results in the delivery of a dead baby. The mother is hemorrhaging, requires an emergency hysterectomy, and is headed to the ICU. The author sits alone crying for one hour. For the next six months, he never laughs. He quits medicine and lands a job as a comedy writer and editor for television. Seriously.




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