Showing 1 - 10 of 755 Nonfiction annotations

Annotated by:
Field, Steven

Primary Category: Literature / Nonfiction

Genre: History

Summary:

John Barry’s The Great Influenza is a deep dive into the history of the influenza pandemic of 1918.  But it is not simply a deep dive into the purely medical aspects of that history—as no medical histories truly are—but is in addition an exploration of the social and political currents of the time that coexisted with and facilitated the pandemic. 

Although his story opens with the establishment of the Johns Hopkins Hospital in 1876, Barry immediately takes a detour into the history of medicine dating back to Hippocrates, and traces the history of medical/scientific thought from Ancient Greece to the end of the 19th century.  He then introduces a series of physicians, scientists, and medical researchers who will play their parts in the story of the pandemic (this first section is called “The Warriors”) and outlines their training, research, and interactions.

It isn’t until page 91 that he takes us to the rural Kansas county in which the story of the pandemic begins.  For although it was called the “Spanish Flu,” that was actually an eponym of convenience; in fact, the first cases of pandemic flu seem to have arisen on the American prairie.  However, newspaper reporting on the new pandemic was felt by the Allies and Central Powers alike to be contrary to the public interest (the war was still raging), so it was left to neutral Spain, whose king had come down with the disease, to publish the early reports.  In this section, “The Swarm”, Barry also briefly reviews the basic (not to worry, very basic) microbiology of viruses and the history of some prior pandemics.  He follows this with the section called “The Tinderbox,” in which he traces the events leading up to the entry of the United States into World War I, and the importance of that war and the political and social conditions surrounding it in the history of the pandemic.  From here on in the influenza itself takes center stage; in sections called “It Begins,” “Explosion,” “Pestilence,” “The Race,” and “The Tolling of the Bell,” the rapid and lethal course of the pandemic is described in gripping (no pun intended) detail.  The last two sections discuss the scientific advances (and some false starts) brought about by the cadre of researchers working day and night to tame the outbreak, and then Barry finally turns to the retreat of the virus and ultimate end of the pandemic.  The book ends as it began, returning to the stories of the individual men and women of science who engaged in the battle to beat the disease of which it had initially been said by many that “[t]his was, after all, only influenza.”  

View full annotation

Annotated by:
Clark, Mark

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

The title of this memoir derives from the Native American custom of bending a tree’s growth in order to indicate a direction of safe passage.  The custom represents a reverent cooperation with nature through which a compassionate communication is accomplished: a message to other journeying souls as to how they might find a way to their flourishing.  The title is exquisitely apt for this memoir, which echoes the gesture of the arrow tree, testifying to a safe passage through the wilderness of COVID.  The author, a first-rate, published Victorian scholar, contracted COVID-19 in March 2020 upon her return from a sabbatical at the University of Cambridge, which was cut short as a result of the pandemic. 

Weliver has suffered from symptoms ever since: hers is the experience of living with long COVID.  The condition warrants her taking a leave from her university, and she returns to her childhood home of Interlochen, in northern Michigan.  Her living in and engaging with the natural world there encourages her to undertake meditations about that world and her place in it as she lives with her illness.  The writing—the foundational means of her healing—inclines her, crucially, to think with the stories of the Odawa (Ottawa) and the Ojibwe (Chippewa), Anishinaabek ("Original Man") of the region, which she researches as a means of deepening her understanding of her home, her origins, and the nature of her identity.  Her quest for understanding turns not only to these stories, but to an integration of them with the wisdom of other guides in her life: authors of the Romantic and Victorian periods, poets and thinkers of Taoism and other ancient Eastern philosophies, mentors in her rich journey of studying both literature and music (she attended Interlochen Center for the Arts, Oberlin, where she double-degreed in English Literature and Voice (Music), Cambridge, and the University of Sussex), and her own family, particularly her mother.  Her prose is accessible and welcoming, not at all the erudite sort one might anticipate from a reputable scholar: it invites curiosity and encourages insight that is, at times, breathtaking and joyous.  This “arrow tree” memoir points its readers in the direction of a safe passage to the home of our natural world, where, in finding union with that world, we may experience healing not only from COVID but from habits of the heart that have left us more broken than we know.

View full annotation

Parenthesis

Durand, Élodie

Last Updated: Apr-23-2021
Annotated by:
Miksanek, Tony

Primary Category: Literature / Nonfiction

Genre: Graphic Memoir

Summary:

Judith, a French woman in her early twenties, experiences "spells" - episodes of shaking, staring, and sudden memory loss. These spells occur daily and her behavior becomes erratic. She visits a neurologist. He diagnoses epileptic seizures and prescribes medication. Yet the convulsions continue so Judith's drug dose is upped and an MRI of the brain is done.

The MRI scan finds a small tumor that appears inoperable. A brain biopsy reveals an astrocytoma. Judith's life now revolves around her illness and the medical monitoring of it. Time feels distorted, and she likens her seizures to "a little death." Everyday life becomes blurred. She is advised to see a neuropsychiatrist. Her parents worry about her constantly.

Eventually Judith is referred for Gamma Knife radiosurgery. Eighteen months after the procedure is completed, only a tiny scar at the site of the tumor remains. Three years following the treatment, the seizures are gone. She rediscovers the joy of life and embraces a hopeful future.

View full annotation

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

Annotated by:
Zander, Devon

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

Fevers, Feuds, and Diamonds is Paul Farmer’s latest work exploring the connection between health and the social and historical structures that surround it.  Focusing on how and why Ebola spread in West Africa in 2014, the book is difficult to categorize — it is not only temporally expansive, ranging from the late 15th century to the present day, but it also combines elements of a memoir, an anthropological treatise, and an abbreviated historical text with powerful calls to action in over 500 pages.   

Stemming partially from a desire to fulfill a “personal penance for inaction” during the early days of the outbreak, Farmer chooses to learn about Ebola from “the personal histories of the Ebola dead, of survivors, and of their caregivers.”  Harking back to his days as a college anthropology major, many of the book’s themes, embodied in its title, are introduced via these in-depth interviews.  His two main subjects, Ibrahim and Yabom, are Ebola survivors who, after initially recovering from their illness, make it their work to support other Ebola survivors.  Through their words and narratives, we witness some of what it was like to experience the civil strife that predated the outbreak, see how Ebola expanded from isolated cases to clusters and communities, how family members sick with the disease were cared for, what it meant to survive Ebola, and now what it means to live with its sequelae.  Translation for Farmer was provided by Dr. Bailor Barrie, one of his former students, whose story as a medical student in Sierra Leone during its civil war soon becomes part of the narrative, as well.  Through the words of these three people, pieced together over many extensive conversations, a narrative is developed, allowing those most impacted by Ebola to tell its story. 

Farmer interweaves his first-person perspective with their stories, emphasizing his role in 2014 and how Partners in Health became involved in assisting in the outbreak.  While working in West Africa during the Ebola epidemic, late one night, Farmer mixes up Liberia and Sierra Leone.  Realizing how different their histories are, he vows to “make amends for my ignorance” and transitions from storytelling on the personal level to history-telling on the country level.  To ensure that he, and we, never mix them up again, Farmer traces the histories of Sierra Leone, Liberia, and Guinea in four chapters.  During this section, he refers back to the book’s title, taking on the effects of the rise of imperialism, colonization, the use of sanitation/Pasteurian principles, the impact of resource extraction, and much more on each of these nation’s stories and relationships with Ebola.  As he describes it, “if you want to understand the magnitude and dynamics of this Ebola epidemic, in other words, think in terms of fevers, feuds, and diamonds.” 

Fevers, Feuds, and Diamonds is bookended with reflections on COVID-19 in the introduction and epilogue.  In the introduction, he reflects on the book’s “obvious implications for our response to COVID-19” and how COVID-19, though different in many ways, shares certain similarities with Ebola — among them, the speculative nature of its origins and the fact that it is a zoonosis.  Most importantly, according to Farmer, treating and managing it will require understanding many of the same “cultural complexities and... challenges” that treating Ebola required.  After taking us on a journey through West Africa and up to 2014, Farmer writes an epilogue reflecting on how the central crisis of Ebola was the prioritization of “containment over care” whereas COVID-19 has become a crisis of containment.  To him, writing this on April 10th, 2020, and to the reader reading it a year later, COVID-19 is seen as partially a disease of healthcare workers’ exposure, and partially a disease of social inequity, but completely a disease whose management, treatment, and eventual control will be defined by the “staff and stuff and spaces and systems” in place and who has access to them.  Even with this pandemic at the forefront of our minds, Farmer reminds us that Ebola should not be off our radar just because a new disease is on it— there continue to be outbreaks of Ebola in the Congo.  Ultimately, Farmer’s words leave you thinking — about this pandemic, about the past, and about the connections between them.  If only to prompt more thought, one of Farmer’s last comments is also his most powerful: “If there’s indeed a lesson to be learned from Ebola, it may be this one:  for everything we do, or say, in pandemic time, let’s keep asking the same question.  Might this help?







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:

The Doctors Blackwell begins with an account of an auspicious new beginning—the opening of The New York Infirmary for Indigent Women and Children, the first women’s hospital staffed by female physicians. Founded in 1857 in New York City by Drs. Elizabeth and Emily Blackwell with the express purpose of providing clinical experience to female physicians, the hospital was a landmark achievement in the long struggle for parity in medical training. The Doctors Blackwell goes on to trace the history of the institution and of its two founders, themselves trailblazing members of the medical profession as the first and third women to earn medical degrees in the United States.

Two of nine children born to abolitionist, Protestant dissenters in Bristol England, Elizabeth and Emily Blackwell were the recipients of a strict moral upbringing. While successful in instilling the values of education and hard work, their childhood also left them socially awkward and with the sense that they were both morally and intellectually superior to those outside of their family. When the Blackwells emigrated to New York City in 1832 and then on to Cincinnati in 1838, their social circles were confined to religious and abolitionist advocacy. Yet soon after the family arrived in Cincinnati their lives were upended by the passing of their father, Samuel Blackwell. With their mother and six siblings to support, the three eldest Blackwell daughters-- Anna, Marian, and Elizabeth-- took up teaching until their younger brothers were old enough to support the family.               

Elizabeth, morally principled to a fault, studious, and determined to succeed intellectually, found teaching to be an unfulfilling means of channeling her energies. Having forsworn marriage at the age of 17, she longed for something challenging and admirable upon which to focus her formidable intelligence. When a dying friend suggested that she become a physician, because she herself would have appreciated a female doctor tending to her disease, Elizabeth’s interest was piqued. Yet her attraction to medicine was rooted not in a desire to help the ailing (indeed she viewed illness as a form of weakness), but in an ideological quest to prove that women were capable of achieving the same distinctions as any man. She saw herself as a moral crusader with the goal of uplifting all of womankind.              

Beginning in 1844, Elizabeth leveraged her teaching connections to gain the backing of several prominent male physicians. Yet the all-male world of medicine remained stubbornly closed to her, and it wasn’t until 1847 that she was admitted to the Geneva Medical College in upstate New York, an event that caused a stir in the medical community and beyond. Isolated both from her male classmates and from laypeople, who viewed her at best as an oddity and at worst as a dangerous anomaly,  Elizabeth nonetheless became a figure equally admired and reviled by the public.  Her reputation as the first “lady doctor” preceded her, even as she gained the respect and admiration of the faculty at Geneva College and distinguished herself with additional training in Europe.                    
 
Meanwhile, the trials of Emily Blackwell, whom Elizabeth encouraged to follow in her footsteps, illustrated that far from breaking down the doors that barred women from medicine, Elizabeth’s admittance may only have served to seal them more tightly. Elizabeth was viewed as a notable exception to the general rule that women were unfit to practice medicine, and her male colleagues were uneasy at the thought of being replaced. But after a prolonged struggle, Emily succeeded in obtaining her medical degree from Cleveland Medical College and joined Elizabeth to hang up her shingle in New York City.              
Increasingly frustrated by the difficulty in recruiting private patients to be seen by female physicians and by the dearth of clinical opportunities for the growing number of women in the field, Elizabeth and Emily opened their own hospital and medical school with the help of female philanthropists. Elizabeth’s philosophical zeal combined with Emily’s true love and aptitude for medicine proved to be a dynamic combination. Their contributions to the field not only changed the way that medicine is practiced, but also paved the way for generations of female physicians. Today, just over fifty percent of the nation’s medical students can trace their acceptance into the profession to the dogged determination of these two extraordinary women.   









View full annotation

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).

View full annotation

Annotated by:
Glass, Guy

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

Genre: Biography

Summary:

Maria Callas, the most famous opera singer of the second half of the 20th century, continues to exert a fascination.  Critical consensus is that Callas fused a technically flawed voice with an extraordinary stage presence to create something unique.  More than forty years after her death, Callas’s recordings continue to be best-sellers, and her life has inspired dozens of biographies.  Prima Donna: The Psychology of Maria Callas appears in Oxford University Press’s Inner Lives series, which consists of psychobiographies of artists that make use of current psychological theory and research.  The focus of author Paul Wink, a psychology professor at Wellesley College, is adult development and narcissism.  

The facts of Callas’s life are well known. She is born in New York City to an ill-matched Greek immigrant couple.  Her father is barely able to keep a roof over their heads.  Her mother Litza struggles to get over the death of an infant son, requiring hospitalization for a suicide attempt. As the story goes, Litza cannot bring herself to look at her new daughter for the first four days of her life.  Litza, who imagines herself in a lofty social class, disdains their neighbors, and thus Maria is discouraged from playing with other children.  When Maria is discovered to have talent, Litza exploits her.   

As Litza’s marriage deteriorates, she brings Maria back to Greece.  With the onset of World War II, they endure hardships.  Yet, improbably, the overweight and awkward Maria shows a streak of brilliance.  She is the hardest working student at the conservatory, quickly outpacing her peers.  On Maria’s first day in Italy, where she gets her first big break, she meets a businessman who is more than twice her age.  Within weeks they are a couple.  For a time, she allows Litza to share in her success, even buying her a fur coat.  But soon, in response to a request for money, she tells her mother to “jump out of the window or drown yourself” (p. 78), and then never speaks to her again.  

Maria loses weight and transforms into the operatic counterpart to Audrey Hepburn.  She enjoys one operatic triumph after another. Nevertheless, she becomes as famous for her bellicose and imperious behavior as for her singing.  She kicks a colleague in the shin after a performance so she can take a solo bow. She is publicly fired from the Metropolitan Opera.  She incurs scandal by suddenly canceling a performance at which the president of Italy is present.   

When the fabulously wealthy Aristotle Onassis courts her, Callas unceremoniously rids herself of her husband.  Soon, her technical flaws catch up with her, and her career dwindles away.  Meanwhile, Onassis goes for a bigger trophy: Jacqueline Kennedy, and Callas is humiliated in the press.  Voiceless, she exiles herself to Paris with her two poodles, develops an addiction to sleeping pills, and dies a decade later, alone.  

View full annotation

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

This engaging and informative book describes the latest scientific understanding of the brain, primarily in humans, but also in other animals. The author, a leading brain researcher, writes clearly and often with humor. 

As Barrett explores the deep history of brains, she emphasizes that as much as some humans may prize thinking, the brain’s central task is not thinking but monitoring and guiding—day and night—the many systems of the body. Brains of all creatures manage a “budget” for various factors such as water, salt, glucose, blood gases, etc., to create an on-going fitness against any future threats.

Our brains and bodies are interlinked, interactive, and unified, not the “triune” brain Carl Sagan popularized in 1977. All animal brains have similar neurons, and all mammals share a “single manufacturing plan” for brain development after birth. Babies’ brains develop according to their genes and in response to their environment, especially to their caregivers. Human brains have flexible networks much like the global air-travel system and can vary from person to person and, individually, over time because of brain plasticity.           

Our individual brains influence—even create—our perceptions and relate to brains of other people through family, language, gesture, culture, and more. Barrett concludes, “Social reality is a superpower that emerges from an ensemble of human brains. It gives us the possibility to chart our own destiny and even influence the evolution of our species” (p. 123). 

View full annotation