Showing 381 - 390 of 869 annotations tagged with the keyword "Communication"

The Enemy

Campo, Rafael

Last Updated: Aug-26-2007
Annotated by:
Davis, Cortney

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

The poems in physician Rafael Campo's latest collection examine familiar themes: lost homelands, the agonies of patients and providers, local and global abuses, love and betrayal, of both the heart and the body.  In this book, Campo expands these themes, writing of child abuse, war, and the certainties and uncertainties of maturing love.  As in his earlier collections, Campo investigates these themes in poems that are expertly crafted and often in form, as if form might contain this poet's empathic and deeply felt connection to the world.  While Campo has always been a reliable witness, especially to the world of healthcare, in this volume his vision becomes even more incantatory, paradoxical and mature.  The narrator's personal losses and responsibilities expand into the universal, into a world that cries out to us to care, to act, to heal, to notice, to tell, to "realize the human" (92).

Divided into four sections, the first section begins with a poem, "Dialogue with Sun and Poet," dedicated to June Jordan, a deceased activist and poet whose poems once made Campo uncomfortable but now mobilize him to "arise."  Following poems tell of local abuses--an abused woman ("Addressed to Her"), the displacement of memory ("Elsa, Varadero, 1934" and "Night Has Fallen"), the crushing of the spirit ("Personal Mythology") and the reality of evil, evil that calls poets to "refuse nostalgia's reassurance that the way was clear" ("Brief Treatise on the New Millennial Poetics").  This section ends with a translation from Neruda's "Book of Questions," a poem that asks if we are in control and if we are indeed capable of change (22).

In the second section, Campo takes us, in sonnets, through "Eighteen Days in France," another country and yet one in which he is still haunted by melancholy, by both sadness and joy--when one sees clearly one cannot leave behind suffering or the potential for suffering.  These sonnets speak of loss, fear, doubt and death grounded in moments of pure happiness.  

The book's third section, "Toward a Theory of Memory," opens with another masterful Neruda translation, one that speaks of love's convolutions, "just as life is of two minds" (47).  Following are exceptionally beautiful poems that speak of the misuse of love and power ("Granymede, to Zeus") and of the deep joy and deep complications of long-married love (see especially "The Story of Us").

Section Four, "Dawn, New Age," is a collection of laments for human selfishness, for war, for the inevitable passage of time, for the emotional depressions we might lose ourselves in, for the patients we cannot cure.  In "Tuesday Morning," the poet says, "No poet cares / for such deceptions anymore, and words / don't cure" (93).  Perhaps words alone cannot cure, but these poems, intelligent and very often incredibly beautiful, can sustain us and remind us that only human connection, human love might help us survive.

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Becoming Chloe

Hyde, Catherine

Last Updated: Aug-10-2007
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Jordy, 17, gay, abused by his parents, has taken refuge in a New York basement from where, one night, he witnesses the brutal gang rape of a young 18-year-old. After his shouted threats scare off the attackers, the girl slips through the window into what turn out to be shared quarters. The two begin to take care of each other; she insists on his getting treatment for head wounds at a public clinic (where care is distiinctly substandard) and he becomes guardian to this young woman whose history of abuse has left her in a curious state of social alienation and innocence about what is normal. The story becomes a kind of vision quest when, faced with "Chloe's" (a name she gives herself by way of starting over) inclination to put herself in harm's way, and to flirt with suicide, Jordy decides to prove to her that the world is more beautiful than it is threatening and ugly.

They acquire an old truck and embark on a cross-country journey that becomes a picaresque series of encounters, most of them with helpful, kind people, one notably disastrous, with three young men who threaten Chloe and land Jordy in the hospital after a fight. The trip terminates in Big Sur on the California coast where Chloe's dream of riding horses on the beach is fulfilled with most of Jordy's remaining cash. The pilgrimage leaves them with a sense of hope which each of them communicates to the New York therapist who briefly helped them, in letters that end the book.

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How Doctors Think

Groopman, Jerome

Last Updated: Aug-06-2007
Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

In How Doctors Think, Jerome Groopman explores clinical decision making with a particular emphasis on the poor communication skills and cognitive errors that often lead to misdiagnosis and inappropriate treatment. He uses a narrative approach, filling the book with compelling stories that illustrate the world of patient-physician interactions. Why did a second doctor quickly conclude that Blanche Begaye suffered from aspirin toxicity, while her first doctor mistakenly diagnosed viral pneumonia? Why did several physicians fail to diagnose Maxine Carlson's ectopic pregnancy until the day it ruptured? Groopman's storytelling skill permits him to convey complex concepts (e.g. availability bias, anchoring, and Ockham's razor) through conversation and narrative.

Three major themes run throughout the book, and each is presented with several variations. The first theme is that doctors who don't listen to their patients are likely to make serious mistakes in diagnosis and treatment. The second is that doctors frequently don't have the self-awareness to understand their own errors, especially those that involve dealing with ambiguity and understanding the importance of emotions. The final theme is that that patients ought to be active participants in their own care. This is not a new message, but Groopman frames it in a new way. Given the complexity of clinical decision making, and the many cognitive errors physicians may fall prey to, patients can improve their own care by helping their doctors minimize or avoid such errors. Among other things this means asking thought-provoking questions like "What else could it be?", "What is the worst thing it could be?," or "Is it possible I have more than one problem?"

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Word of the Cure

Glowney, John

Last Updated: Jul-13-2007
Annotated by:
Kohn, Martin

Primary Category: Literature / Poetry

Genre: Poem

Summary:

The poet beautifully captures the connection between a successful neurosurgical operation that restores "the jitterbug of impulses" of the brain, with the neighbors' "word of the cure." He likens the neighbors' conversations to "the way, in Montana prairie country, / the first telephones let the local secrets / and sorrows pour through the survey-staked / barbed-wire fences now doubling / as makeshift transmission lines."

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Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Collection (Essays)

Summary:

This collection of essays by surgeon-writer Atul Gawande (author of Complications: A Surgeon's Notes on an Imperfect Science --see annotation) is organized into three parts (Diligence, Doing Right, and Ingenuity) and includes an introduction, an afterword entitled "Suggestions for becoming a positive deviant," and reference notes. Each part is comprised of three to five essays, which illustrate, as Gawande explains in the introduction, facets of improving medical care - hence the title of the collection: Better: A Surgeon's Notes on Performance. In typical Gawande style, even the introduction contains tales of patients - a woman with pneumonia who would have fared far worse had the senior resident not paid close and particular attention to her well-being, and a surgical case delayed by an overcrowded operating room schedule. Such tales are interwoven with the exposition of themes and the detailing of the medical and historical contexts of the topic at hand.

The essays, though loosely grouped around the improvement theme, can easily be read as individual, isolated works. The concerns range widely both geographically (we travel to India and Iraq as well as roam across the United States) and topically. For instance, we learn about efforts to eradicate polio in rural south India and the dedicated people who devise and implement the program. Another essay, far flung from the plight of paralyzed children, is "The doctors of the death chamber," which explores the ethical, moral and practical aspects of potential physician involvement in the American system of capital punishment (from formulating an intravenous cocktail ‘guaranteed' to induce death to the actual administration of such drugs and pronouncement of death).

In sum, the topics of the eleven essays are: hand washing, eradicating polio, war casualty treatments, chaperones during physical examinations, medical malpractice, physician income, physicians and capital punishment, aggressive versus overly-aggressive medical treatment, the medicalization of birth, centers of excellence for cystic fibrosis treatment, and medical care in India. The afterword comprises five suggestions Gawande offers to medical students to transform themselves into physicians who make a difference, and by including this lecture in the book, what the reader can do to lead a worthy life.

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The Violinist

Zivkovic, Zoran

Last Updated: Jun-11-2007
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

A Princeton professor has less than one night to live. His physician visits him in the hospital late in the evening. Dr. Dean is uncomfortable interacting with the dying man. He feigns optimism about the clinical situation and offers false hope but avoids eye contact with the professor and urgently exits the room. A compassionate nurse, Mrs. Roszel, is on duty. Before bedtime, she gves the professor a blue pill that dampens the constant pain in his stomach and also provides a pleasant sensation of weightlessness.

Out of nowhere, he hears a beautiful melody played on a violin. It is barely audible and imperceptible to the nurse. The professor has been a violinist since his youth, and the music triggers a flashback. Sixty years earlier, as a 15-year-old boy, he visited a small town in Italy. The silence of the village was punctured by heavenly violin music. Time slowed and then stopped. Light surrounded and permeated him before giving way to absolute darkness. Was it enlightenment or heatstroke? He awoke and saw a priest hovering over him.

Like that day long ago, the violin music now playing in his hospital room is still a revelation. The harmony reveals the mystery of the universe - the connection between time and space and light. Suddenly it is imperative that the professor shares this new knowledge before he dies. Calling fo Nurse Roszel, he attempts to impart to her what he has just discovered. She is baffled by the language but listens intently anyway.

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The Foreshadowing

Sedgwick, Marcus

Last Updated: Jun-07-2007
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel for Young Adults

Summary:

It is 1915. Sasha, only daughter of a renowned English doctor, longs to be a nurse, as her brother, Thomas, longs to be a doctor. Their father is opposed to both objectives: he thinks Thomas should sign up to "do his bit" in the war effort like his older brother, Edgar, rather than go to medical school, and he doesn't think Sasha could handle the gore of wartime medicine. He is also concerned because on a few occasions, Sasha has let slip that she has accurate premonitions of people's deaths. The first of these came when she was five. She has learned since then not to speak of this "gift" to anyone in her family, for fear of losing credibility, but keeps with her a book of Greek myths, in which the story of Cassandra helps her to validate her sense of her own gift/curse.

Sasha does persuade her father to let her try her hand in the hospital as a VAD (Voluntary Aid Detachments)--a minimally trained caregiver--but gets herself thrown out when it is found out that she has been commuincating with a shellshocked patient and also that she foresees patients' deaths. The people around her are afraid of her powers. So she runs away to the front, looking for her brother, Thomas, who keeps appearing in a dream with a bullet whizzing toward him.

An eccentric young soldier who works as a courier appears to have a gift similar to her own. He goes AWOL with her to the place near the Somme where her brother's unit is fighting. When she finally locates Thomas, he is determined to return to the fighting, but, as she understands what mass slaughter is afoot, she shoots him herself to wound him, so he can't return. This surprise ending works to cap the various questions the book raises about how desperate times call for desperate measures.

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Kira Kira

Kadohata, Cynthia

Last Updated: Jun-07-2007
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel for Young Adults

Summary:

Katie Takeshima, the narrator of this coming-of-age novel, moved with her immigrant family from Iowa to Georgia when she was in kindergarten. As her parents work long hours in a poultry processing plant with other exploited non-union immigrant workers, she and her older sister Lynn, and her little brother, Sammy, enjoy a loving and fairly free childhood. Lynn is Katie's primary teacher. Among her most important lessons is to see everything around her as "kira kira"--a Japanese word meaning something like "glittering"--moving and alive. When Lynn sickens and then dies of lymphoma, Katie has to do some fast growing up, and in her mourning develops a sharper sense of the glittering, mysterious presence of spirit and life in a world full of prejudice, poverty, and loss.

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Angel's Choice

Baratz-Logsted, Lauren

Last Updated: May-30-2007
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel for Young Adults

Summary:

In her senior year of high school, having uncharacteristically drunk too much at a party, Angel Hansen consents to be taken home by a boy she normally doesn’t care much about, and ends up having sex with him. Two months later, with the help of her best friend, Karin, she takes a pregnancy test, finds it is positive, and visits an abortion clinic. Karin, who has had an abortion, is ready to support her in complete secrecy. Tim, the father, is horrified, but consents to pay for the procedure. At the last minute, however, and without being able to explain her reasoning to either of them, Angel decides not to go through with the abortion.

In the ensuing months, she endures her parents’ disappointment, her friends’ distancing, and the loss of a number of hopes, including the Yale education she was expecting. In the course of those months, however, she also finds new levels of relationship evolving with parents, grandparents, and the few friends who decide to engage with her on new terms, including Danny Stanton, a friend she’d grown up with, and had recently come to love in new (but, she thought, hopeless) ways. To her great surprise, Danny asks to accompany her to Lamaze classes, and, after taking her to the prom in her ninth month, sees her through the baby’s birth. The story, told in the first person in the form of journal entries, chronicles a young woman’s process of maturing through the consequences of a mistake into acceptance of responsibility for choices, even one she can’t fully account for.

One interesting scene records a conversation between Angel and Karin where Karin admits that her weeks-long estrangement comes from a feeling that Angel’s choice to keep the baby implies a judgment of her for terminating her own earlier pregnancy. Angel makes it clear that she respects their differences, fosters no judgment, and can’t even fully articulate why she felt strongly about needing to make a different choice, but feels clear and sure about her own.

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Annotated by:
Kohn, Martin

Primary Category: Literature / Fiction

Genre: Collection (Short Stories)

Summary:

Jay Baruch offers readers a series of multi-layered stories focusing on caregivers, both professionals (doctors and nurses primarily) and family members, and those they are trying to care for. The setting for a number of the stories (and therefore a number of the characters) is from the working class or underclass. Another group of stories is written from the perspective of medical students, residents or physicians early in their training. In all the stories, the characters' lives are close and full of conflict. The language they use to express themselves is raw and direct. There are no simple solutions to their problems. Yet struggle on do these characters, testing the limits of their compassion and abilities to deliver care at least competently.

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