Showing 1 - 10 of 269 annotations tagged with the keyword "Infectious Disease"

Annotated by:
Teagarden, J. Russell

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

Carlo Cipolla chronicles the 1630 bubonic plague outbreak in Northern Italy. At various places in the text, he refers to his compact volume as an “essay,” a “tale,” and a “book.” Readers during the 2020 coronavirus pandemic could call it a “prologue,” a “warning,” or a “horror story foretold.”  

The plague ravaged much of Northern Italy from 1630 to 1631. Cipolla focuses on a particular village, Monte Lupo, because “so exceptionally rich is the documentation of [its] story that it allows the historian to recapture emotions, attitudes, and behavior of common people.” The documentation led him to uncommon detail “on the relationship between Faith and Reason, Church and State at a social level” (p. ix). 

Reading like an historical essay, Cipolla first sets up the tensions arising between the Church and State Church during the plague epidemic. The “scientific revolution” had advanced enough by 1630 that regional Health Magistrates acted based on experience rather than faith. Most clergy and their followers still “preferred to believe rather than observe…[and] had not the slightest doubt: processions and similar ceremonies were the only way to placate divine wrath and put an end to the scourge” (p. 7). But, the divide between Church and State in this case is not so clear as that, Cipolla notes, because some of the senior Health Magistrates served as high-ranking church leaders themselves. 

Cipolla points to public health measures taken in Northern Italy before the 1630 plague outbreak that might have, ironically, heightened tensions, even though they were born from the terror and suffering epidemics caused during the previous two centuries. The changes that resulted were, in Cipolla’s view, “a strange mixture of brilliant intuition, sound common sense, and absurd prejudice” (p. 12). However rational these measures seemed, “they caused great misery and severe privations [through] the segregation of entire families in their homes, the separation of kindred in the horror of the pesthouses, the closing of markets and trade, the consequent lack of work and wide-spread unemployment, the burning of furnishings and goods” (p. 13). By the time the plague took hold in 1630, necessary public health measures were already unpopular.
 

Cipolla uses the walled-village Monte Lupo as his case study. Around 150 families lived inside its walls when the plague struck during the summer of 1630. He details how Health Magistrates struggled to gain control of the outbreak while facing open rebellion fueled by “ignorance, egoism, avarice, and bullying” (p. 14). He names and profiles key figures and describes various events. 

The central event in Cipolla’s tale is a “procession” in Monte Lupo featuring a crucifix people believed had “miraculous properties” (p. 41). The Health Magistracy took aggressive actions to prevent and then stop the procession. Alas, Cipolla reports: “All this was in vain. It was like preaching to the wind: the church was soon packed with men and women, boys and girls, who had come to gaze at and adore the crucifix,” (p. 47). Festivities carried into the evening and on to a neighboring town (San Miniatello). Mayhem, illness, and death ensued. 
 

The last death in Monte Lupo occurred on August 11. Cipolla follows the subsequent investigations searching for people encouraging exposure to a lethal, contagious disease, and for people who became infected and died as a result. He reflects on the juxtaposition of epidemiological methods used to stop the epidemic and the fight religious leaders and followers waged against them. He muses about “emotions, attitudes, and behavior of all segments of a society in a period distant in many ways from our own” (p. 85). Written in 1977, the objects of his musing were only four decades distant from becoming evident again. 

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Annotated by:
Zander, Devon

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

House on Fire:  The Fight to Eradicate Smallpox is a memoir written by William H. Foege, the physician best known for developing the strategy of ring-vaccination in the eradication of smallpox.  Concisely put by New Scientist, his book is “a mixture of memoir, dry public health guide, and riveting tale of an all-consuming mission.”   

Though a brief read, House on Fire is comprehensive on each of these fronts.  Foege walks us through his life, starting first with his upbringing in Washington state and ending with his role in India as part of the smallpox eradication team there.  Notably, the book’s narrative ends before Foege’s tenure as CDC Director in the late 1970s and early 1980s, focusing explicitly on his involvement in combating smallpox.  Using his career in public health as a framework, he details how he became involved in global health and how each deployment around the world, whether for the CDC, WHO, or Peace Corps, added to his understanding of contagious disease and of how to better approach smallpox containment.  Ever the epidemiologist, Foege does not shy away from including graphs and charts to emphasize his points, especially as they relate to public health data collection.  He takes the reader behind the scenes of conferences, regular meetings, and everyday discussions to show the collaboration necessary for global health work, the planning needed, and the good-natured humor and guile it often requires.  At times, his interactions seem like a who’s who of American public health:  throughout his career, he works with D.A. Henderson, Alexander Langmuir, David Sencer (who also writes the book’s foreword), and Don Francis.  

Outside of his own history, Foege acknowledges that in order to understand smallpox and to understand the mission of eradication it is necessary to understand the disease’s complex history.  He begins the book with the history of smallpox and details the development of the vaccine from its crude precursor, variolation, to Edward Jenner’s early version derived from cowpox.  As he progresses through his story, he notes important historical moments in the battle against smallpox:  the development of the jet injector and bifurcated needle as ways to better administer the vaccine, the elimination of the virus first from countries and then whole continents, and, most poignantly, the final cases of smallpox ever recorded.  

Though the book necessitates some level of public health knowledge, or at least a comfort with viral disease and baseline public health interventions, it consolidates its role as a basic public health guide at the appendix.  In the last pages, Foege reflects on what to do if there were ever a bioterror attack with smallpox, complete with a diagram on how to administer the smallpox vaccine.  

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5B

Haggis, Paul; Krauss, Dan

Last Updated: Apr-17-2020
Annotated by:
Teagarden, J. Russell

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

5B is a documentary about the special unit created at San Francisco General Hospital (Ward 5B) in 1983 to take care of people with AIDS. Three years later, it moved to the larger Ward 5A, where it remained in operation until 2003 after the introduction of treatments effective enough to drastically reduce the demand for hospitalization and standards of care for AIDS patients were in place throughout the hospital. The documentary covers the medical, social, and political considerations surrounding the opening of Ward 5B, and the AIDS epidemic during that time.

The story is told from various perspectives through interviews with key figures in its development and operation, and archival footage of the ward and AIDS activism in the community. The most prominent among the key figures is Cliff Morrison, a clinical nurse specialist who spearheaded the idea for the unit and then managed it. Several other nurses who served in staff and supervisory positions are featured. Participating physicians include Paul Volberding, an oncologist at the time who became pivotal in the development of effective HIV treatments, and  Julie Gerberding, a physician treating patients on the unit who later became the Director of the Centers for Disease Control (CDC). Lorraine Day, the chief of orthopedic surgery at the hospital when the unit opened is heard often as an opposing voice. Hank Plante, a local television news reporter also appears frequently to offer his perspectives on many of the social and political issues swirling around the unit. Among other participants are AIDS activists, volunteers, and family members of patients on the unit.

Several storylines frame the documentary including how nurses drove the unit’s inception and then were instrumental in running it. “Nurses were in charge,” said Volberding, admiringly. Interwoven throughout the film are the experiences of the patients and individual nurses, including one nurse who was infected with HIV from a needle stick. “Those nurses were the real heroes,” said one activist.  

The unit and those who worked there also encountered opposition from inside the hospital. The nurses of this unit practiced in ways they considered safe but not in such a manner that would preclude them from touching patients or require that they don so much protective gear they become unseeable. Nurses and other clinicians from other parts of the hospital objected and did not want to be compelled to adopt practices they thought endangered them on the occasions they took care of AIDS patients. The film follows this story through union grievances and public debates to their conclusion, which sided with the unit nurses and their advocates.

The story is told against a backdrop of gay rights activism in the 1970s that led to AIDS activism with its influence on how the unit operated. Also getting attention is the fear AIDS struck in society and the resulting social backlash at a time of federal government insouciance. This fear continued up to the time the federal government recognized the epidemic and began taking action, relieving some of the tension but never eliminating it. The documentary ends with key participants reflecting on their experiences with the unit; most were proud, some bitter, and a few a little of both.

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The Ballad of Typhoid Mary

Federspiel, J. F.

Last Updated: Apr-07-2020
Annotated by:
Belling, Catherine

Primary Category: Literature / Fiction

Genre: Novel

Summary:

The novel's narrator is a widowed 58-year-old Swiss-born physician, Howard J. Rageet, who lives in New York City. His son is a pediatrician, his daughter a medical student. Rageet himself is terminally ill. He is writing a "little biography," of Mary Mallon, the infamous "healthy carrier" also known as Typhoid Mary. Rageet's grandfather, also a doctor, had kept a journal about Mary and his rivalry with his friend, (the real) George A. Soper, whose life's work became tracking Mary and proving that she was responsible for the typhoid outbreaks. Elaborating on the journal, Rageet recounts Mary's life in America.

Born Maria Anna Caduff in the same part of Switzerland as Rageet's ancestors, she arrives in New York Harbor in 1868, aged 13, on a crowded immigrant ship, a fifth of whose passengers had died en route from Europe. The dead include Mary's family. She had been taken care of by the ship's cook, who evidently both taught her to cook and used her for sex. When the ship docks, Mary tries to jump overboard, but is stopped by a physician, Dorfheimer, who smuggles her through Ellis Island and takes her home with him. He is also a pedophile, and he has sex with her. Rageet calls this kidnapping a "humane, benevolent crime." Not long after, Dorfheimer dies of typhoid fever.

Rageet's "ballad" then traces Mary's various positions as a cook (and, often, sexual object), most of which end quickly when the household is infected. She has two relationships that do not lead to the disease. One is with a small girl who has Down Syndrome. Once her connection to typhoid is suspected, the child's family hire Mary to live alone with the child and care for her, hoping the child will be infected and die. The child never becomes ill. The other is with a disillusioned anarchist, Chris Cramer. She lives with him and falls in love with him, but he is not sexually interested in her.

Soper encounters Mary when he is asked by a wealthy Oyster Bay family, her former employers, to investigate a typhoid outbreak in their household. He manages to track her down and eventually, after much resistance, she is arrested, tested, and quarantined. She escapes and continues to work as a cook until her re-arrest. Promising to try and imagine Mary's motives, Rageet breaks off his narrative. He is dying. The novel ends with a postscript written by Rageet's daughter. Implying that her father committed suicide, she tells of Mary's stroke and the last years of her life as a paraplegic, and she provides a final document, the menu for one of the very elaborate meals Mary would have cooked.

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BPM (Beats per Minute)

Campillo, Robin

Last Updated: Feb-20-2020
Annotated by:
Zander, Devon

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

BPM is a fictional, French film about ACT UP Paris in the 1990s.  Directed by Robin Campillo, himself a veteran of Paris’s ACT UP, the film details the realities of being an HIV/AIDS political action group during an era of governmental inaction and lack of recognition of those most impacted by HIV and AIDS.  Initially, BPM focuses on the collection of individuals who make up ACT UP Paris and how they organize themselves to protest and advocate for greater media attention, better sexual education, and more access to new pharmaceutical data, among a myriad of other causes.  The film eventually shifts its focus from ACT UP as a group to two of its members, a couple, one of whom, Sean, is struggling with AIDS and Nathan, his partner, who supports him together with the the rest of ACT UP. 

In addition to its presentation of HIV activism, BPM documents what it meant to be HIV positive in a world without highly active antiretroviral therapy and where those most affected were largely ignored or even viewed with disdain.  Historical references ground the film firmly in the 1990s, including allusions to France’s infected blood scandal when hemophiliacs were knowingly given infected blood products, discussions that led to the initial development of protease inhibitors, and ACT UP Paris’s 1993 protest on World AIDS Day when a large pink condom covered the obelisk in the Place de la Concorde.  Contrasting with these larger historical references are daily moments of living with HIV in this era. Members of ACT UP are shown taking AZT and DDI around the clock (including ensuring to pack water during a protest, in case of arrest, when they may need to take medication in jail), regularly attending the funerals of friends who died of AIDS, and enduring moments of homophobia from those outside of ACT UP.



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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:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Sunita Puri, a palliative care attending physician, educates and illuminates the reader about how conversations about end of life goals can improve quality of life, not just quality of dying, in her memoir, That Good Night: Life and Medicine in the Eleventh Hour. Thirteen chapters are grouped in three parts: Between Two Dark Skies, The Unlearning and Infinity in a Seashell. The arc of the book follows Puri as she is raised by her anesthesiologist mother and engineer father – both immigrants from India – Puri’s decision to enter medical school, her choice of internal medicine residency followed by a palliative care fellowship in northern California and her return to practice in southern California where her parents and brother live. Besides learning about the process of becoming a palliative care physician, the reader also learns of Puri’s family’s deep ties to spirituality and faith, the importance of family and extended family, and her family’s cultural practices.

Puri writes extensively about patients and their families, as well as her mentors and colleagues. She plans and rehearses the difficult conversations she will have with patients in the same way a proceduralist plans and prepares for an intervention. She provides extensive quotes from conversations and analyzes where conversations go awry and how she decides whether to proceed down a planned path or improvise based on the language and body language of her patients and their family members. We visit patients in clinic, in hospital, and at home, and at all stages of Puri’s training and initial practice. Some of the most charged conversations are with colleagues, who, for example, ask for a palliative care consultation but want to limit that conversation to a single focus, such as pain management. We also learn of the differences between palliative care and hospice, and the particularly fraught associations many have with the latter term. She feels insulted when patients or families vent by calling her names such as “Grim Reaper” or “human killer” (p. 232), but understands that such words mean that more education is needed to help people understand what a palliative care physician can do. 

As a mediator of extremely difficult conversations, where emotions such as shame, guilt, fear, helplessness and anger can swirl with love and gratitude, Puri finds the grace to acknowledge that all such emotions are part of the feelings of loss and impending grief, and to beautifully render her reflections on these intimacies: “Yet although I am seeing a patient because I have agreed that they are approaching death, if I do my job well, what I actually encounter is the full force of their lives.” (p. 206) Having met many dying people she notes: “Dying hasn’t bestowed upon them the meaning of life or turned them into embodiments of enlightenment; dying is simply a continuation of living this messy, temporary life, humanly and imperfectly.” (pp 221-2)
 

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Survivors

Pratt, Arthur

Last Updated: Jul-19-2019
Annotated by:
Thomas, Shawn

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

For much of the western world, the Ebola crisis came and went without much fanfare. Perhaps we were jolted by the initial news stories, taken aback by the images from affected areas, and slightly unnerved by the travel advisories as we entered security lines at the airport. But for the most part, the Ebola outbreak was an abstract crisis affecting people on the other side of the world, multiple continents away. The closest that most Americans came to Ebola was to hear in the news about the four diagnosed cases in Texas and New York City. It is safe to say that most of the world remains unaware of the depths of this crisis in the West African hotspot countries of Liberia, Sierra Leone, New Guinea, and Nigeria.  

Arthur Pratt is a Sierra Leonian pastor and filmmaker, and he witnessed firsthand the invisible enemy that threatened to destroy his country, the communities, and the families that lived there. Despite the human cost that this disease extracted from the West African people, Pratt was inspired by how the people in Sierra Leone rose up to defend their country from a viral invasion that was attacking “the fabric of what it means to be African.” He felt it necessary to tell the world the story of Sierra Leone’s unsung heroes, and so he created a documentary titled Survivors, which focused on the work done by the ambulance drivers and nurses, interwoven with personal stories of children, mothers, fathers, and communities touched by the disease. Survivors gets up close and personal to the 21-month battle against Ebola in West Africa, and shows how the common people of Sierra Leone risked everything to come together and fight back against an existential threat.

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The Big Sick

Showalter, Michael

Last Updated: Dec-03-2018
Annotated by:
Jiang, Joshua

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Kumail Nanjiani is a Pakistani-born American living and working in Chicago. In addition to driving for the ride-sharing company Uber, Kumail performs as a stand-up comic at a local club, hoping to be noticed and land a big break. During one of his shows, he meets a graduate student named Emily Gardner, and the two quickly develop an intimate relationship.  

Kumail hides his relationship from his family, because they insist that he only date Pakistani women. Privately, Kumail struggles not only with the cultural expectation of intra-ethnic marriage, but also with other aspects of his heritage, such as devotion to Islamic religious law. He chooses to maintain appearances out of love for his family and fear of disownment. Emily eventually discovers Kumail’s double life and in anger, ends their relationship.  

Kumail and Emily’s estrangement is interrupted when Emily is hospitalized with a mysterious illness. Emily initially resists Kumail’s presence, but her sickness worsens and she is placed in a medically-induced coma. Under these increasingly uncertain circumstances, Kumail partners with Beth and Terry—Emily’s parents—to navigate a confusing medical system and chart the best course of care for Emily. The three of them clash over their differing perspectives on care and their interpersonal relationships. As he waits with bated breath for Emily’s recovery, Kumail is forced to confront his values and decide whether his desire to please his family and his ongoing affection for Emily can coexist harmoniously.

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Essex Serpent, The

Perry, Sarah

Last Updated: Sep-07-2017
Annotated by:
Ratzan, Richard M.

Primary Category: Literature / Fiction

Genre: Novel

Summary:

The idea for her second novel came to Sarah Perry in a flash (Ref. 1) as her husband was telling her about the 1699 sighting of a serpent or dragon in Henham, a village slightly to the northwest of the town of Essex, where Ms.Perry was born in 1979. The late 19th century events of the novel occur primarily in Aldwinter, a fictional fishing village on the Blackwater estuary.  Divided into 4 books (with titles derived from a 1669 pamphlet on the Serpent), each with subdivisions by month, further subdivided into chapters, the story takes place over 11 calendar months, from New Year's Eve to November, 1892. Although the story does not feel complicated and should not be difficult to describe in a synopsis, it is a tribute to the novelist's Dickensian talents  that in fact it is somewhat complex, involving four couples and their various children and friends and their increasingly intricate relationships, all revolving around the palpable feeling in Aldwinter that the famous Essex Serpent has returned, resurfaced, or decided to re-animate all the lives therein. The protagonist is Cora Seaborne,  a recently widowed free-thinker, adept in biology and natural sciences, and mother of an adolescent boy, Francis, who would nowadays probably receive the label "autistic." After the death of her abusive husband from oropharyngeal cancer, Cora becomes emotionally involved with Luke Garrett, the treating surgeon, an idiosyncratic, brilliant man, who has a bosom buddy, George Spencer (simply called "Spencer"), a very wealthy former medical school classmate. With an introduction from her friends Charles and Katherine Ambrose, Cora and Martha - her intimate companion - visit William (often referred to as just "Will") and his wife Stella Ransome in Aldwinter, where Will is the parish minister and father to three children. The eldest is Joanna, a precocious adolescent girl one imagines, alongside a younger Cora, as a younger version of this novel's author, who describes herself as vibrantly curious of all her surroundings while growing up in Essex as a young girl. (Ref. 2)

With the arrival of Cora and Martha in Aldwinter, the narrative begins in earnest with the development of the mounting anxiety over the mysterious events (a missing boat, unexplained drownings) attributed to possibly a resurgent Essex Serpent besetting Aldwinter; Luke's miraculous operation saving a man named Edward Burton from a knife wound to the heart; the increasingly romantic relationship between Cora and Will, to Luke's dismay; Stella's rapidly progressive pulmonary tuberculosis; the disappearance of Naomi Banks, a friend of Joanna; and an attack on Luke by the same man who had knifed Edward Burton. By novel's end, without spoiling the plot, most loose ends have been cauterized, left more neatly dangling or deftly retied.  


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