Showing 1 - 10 of 74 annotations tagged with the keyword "Eating Disorder"

Annotated by:
Glass, Guy

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

When Rachel Aviv, the author of Strangers to Ourselves, was six years old, she simply stopped eating.  She said she got the idea from the Yom Kippur fast.  She was promptly checked into a psychiatric hospital where she became one of the youngest-ever patients to be given the diagnosis of anorexia.  Through associating with older, more seasoned anorexic girls she became a sort of “anorexic-in-training” (p.13). Fortunately, after a few months she snapped out of it, and was discharged.  She never suffered from the same symptoms again.   

As an adult, Aviv began to think about what had happened to her.  The only remnant of her experience was a diary entry from age 8: “I had a diseas called anexexia” (p.231).  Had she even had the disorder, or had the diagnosis been a mistake?  Why had she not gone on to have “an anorexic ‘career’” (ibid.), while one of the girls who had mentored her ultimately died of anorexia-related causes?   In order to answer these questions for herself, Aviv meets with the therapists who treated her more than thirty years ago as well as with the family of her deceased copatient.   

As a result of Aviv’s introspection, she becomes intrigued by people whose psychiatric diagnoses do not fully capture the complexities of their situation.  Strangers to Ourselves presents detailed case histories of several such individuals.  Bapu is an Indian woman whose visions have caused her to be diagnosed with schizophrenia.  Are they delusions, or is she a mystic?  Naomi is a socially disadvantaged black woman who has struggled unsuccessfully to get ahead.  During a manic episode, she jumps into a river with her young twins, one of whom dies. Her claim that “white people are out to get me” (p. 146) is ignored because her doctors insist that “delusions couldn’t on some level make sense” (p. 150). Yet another woman, Laura, bounces from diagnosis to diagnosis, and sleeps fourteen hours a day because of all the medication she is on.  She becomes one of these people who no longer even know if their lack of functioning is “due to their underlying disorder [or] the heavy medications they’d taken for it” (p. 203).      

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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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Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Nonfiction

Genre: Autobiography

Summary:

The narrator tracks a hypothetical week in the life and work of a psychiatrist in a major Canadian hospital through the stories of individual patients, some of whom were willing to be identified by name.   

The book opens with “they are us” and the shocking discovery that a patient whose life has been ruined by mental illness is a medical school classmate.  

Other patients have been followed for many years—a woman with eating disorder, a man with bipolar disease, another with schizophrenia. A new patient with intractable depression finally agrees to electroshock therapy, and the first treatment is described. The painful duty of making an involuntary admission pales in contrast to the devastation of losing a patient to suicide.  

Goldbloom’s personal life, opinions, and worries are woven throughout with frank honesty. His mother’s metastatic brain tumor sparks the associated intimations of his own advancing age and mortality.  His genuine fascination with and appreciation of the effective modalities now available are matched by his frustration over how they are beyond reach of far too many because of the stigma that is still attached to mental illness and the lack of resources and political will to make them available.

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So Much For That

Shriver, Lionel

Last Updated: Jan-18-2018
Annotated by:
Teagarden, J. Russell

Primary Category: Literature / Fiction

Genre: Novel

Summary:

The book opens with Shep Knacker packing his bags for his long-dreamed of “Afterlife”—his word for retirement—in Pemba, an island off the coast of Tanzania. He plans to take his wife, Glynis, and his high school aged son, Zach. This plan is not unexpected because Shep and Glynis have made many “research” trips during their 26-year marriage to find the right place (though never to Pemba). But, there were always reasons not to act on their research. An intervention was needed. Glynis is not home while he is packing because she is at some “appointment.” When she gets home, Shep informs her of his plans for the three of them to leave for Pemba, and he further informs Glynis that he’s going whether she comes or not. In response, she informs him that she has cancer—a bad one (mesothelioma); he unpacks, so much for that.

What unfurls from there is more complicated than just the challenges Glynis’s disease produces, though these are monumental challenges. Other people, too, are in need of Shep’s attention. His father’s decrepitude is advancing, his sister is on the brink of homelessness, and his teenage son is detaching from him and life in general. Shep eventually loses his job as an employee at the handyman company he once owned (“Knack of All Trades”) then sold to fund his Afterlife. There’s more. 

Shep's best friend, Jackson, who also worked with him at Knack of All Trades has two girls, and one of them has familial dysautonomia. This progressive genetic disease of the nervous system produces a constellation of medical problems that are bizarre, intense, and serious, before it ultimately produces a tragic end. The trauma and tragedy this disease inflicts in this story (and in life) encompass the entire family, in spite of the heroic efforts of Jackson’s wife, Carol. 
 
The many plot lines in this novel at times proceed independently of one another, and at other times intersect. They concern serious illness experiences and the effects they have on families and also how the American health care system can place burdens on those who need it. Nevertheless, the two families, beaten down by illness, fatigued from encounters with doctors and hospitals, and exasperated from fights with insurance companies, rally enough to make it to Pemba. The trip becomes financially affordable as the result of some narrative gimmickry involving a financial settlement of $800,000 from the company that put asbestos in equipment Glynis had used years before. They would spend the rest of their lives there, longer for some than for others.   

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Life & Times of Michael K

Coetzee, J. M.

Last Updated: Jan-09-2018

Primary Category: Literature / Fiction

Genre: Novel

Summary:

A civil war rages inexorably in J. M. Coetzee’s novel, Life & Times of Michael K. Details of the war are vague, but the fighting will determine whether “minorities will have a say in their destinies” (Coetzee 157). Riots splinter communities, peoples are displaced, the military patrols and slaughters, and prison camps are erected. The novel’s first half introduces an unlikely protagonist at the center of the bloody tumult: Michael K, a municipal gardener—a gentle “simpleton” with a harelip “curled like a snail’s foot”—who cares for his ailing mother in Cape Town (3). Sick and unable to work, K’s mother resolves to return to her birthplace and girlhood home, Prince Albert, a far-flung cluster of homesteads in the Karoo, where she hopes to convalesce peacefully. Their migration permits, however, never arrive, likely lost in the abyss of State bureaucracy. Gathering his mother and their few possessions in a makeshift wheelbarrow, K attempts the arduous journey anyway but the passage is thwarted by a government checkpoint. As his mother’s condition deteriorates, she is hospitalized and dies, her body cremated before K gives hospital officials consent.  

The novel’s lulling elliptical cycle pushes K along the currents of departure and circumvention, to capture and escape. Pressing on to Prince Albert where he will deliver his mother’s remains, K is arrested and incarcerated in a railcar where he and other prisoners remove landslide rubble from a remote part of the rail line. Released after finishing the labor, K arrives to Prince Albert where he settles on the property of the ramshackle homestead and begins contentedly scavenging. Far from the tremors of war, he hunts birds, nibbles roots and bulbs, turns over rocks for grubs, drinks from streams, and, in a fit of wild hunger, drowns and slaughters a wild goat. All the while he finds a package of pumpkin and melon seeds that for the rest of his time on the property he will sedulously plant and water— “[t]his was the beginning of his life as a cultivator” (59). Immersed in this blanched world, at the center of its arid winds and mineral expanses, K devotedly coaxes his mean crop to life. But the war encroaches on K’s hiding place and he absconds to a mountain cave where he hides, and nearly starves.  

The stillness, silence, and sunlight of the Karoo seep into K’s bones: “If I were cut, he thought, holding his wrists out, looking at his wrists, the blood would no longer gush from me but seep, and after a little seeping dry and heal. I am becoming smaller and harder and drier every day” (67). Imperceptibly, K becomes the ephemeral ‘stuff’ of this harsh land: “He thought of himself not as something heavy that left tracks behind it, but if anything as a speck upon the surface on an earth too deeply asleep to notice the scratch of ant-feet, the rasp of butterfly teeth, the tumbling of dust” (97). K is shortly captured by the military and forced into a resettlement camp. Through the elliptical current of the novel, he escapes and returns to the Prince Albert homestead, where he finds his crop trampled. He nourishes the vines back to life and, in a moment of lonely exaltation, grills pumpkin flesh: “All that remains is to be a tender of the soil. […] He chewed with tears of joy in his eyes” (113). What K seeks, or what is seeking him, is a life of solitude, remote from peril and unrest, living in quiet reciprocity with the earth, exercising simple cultivation—a skill conspicuously anachronistic (but universally essential) in an age marked by the depravities of war.  

Wringing nourishment from veld-grown pumpkins, however, leaves K famished, and winds and squalls gut his makeshift shanty. Soon K is picked up, again, by a military patrol (he is suspected of abetting rebels camping in the mountains) that consigns him to a government hospital. The novel’s latter half is narrated by the hospital’s medical officer, a caring man who, doubtful of the war’s objectives, takes special interest in K’s recovery. By now, severely malnourished, K resembles “someone out of Dachau” (146). The medical officer is baffled by K, not for his uncooperative responses nor refusal to eat hospital food, but because of his status as a kind of ahistorical oddity in a time of modern warfare: “a human soul above and beneath classification, a soul blessedly untouched by doctrine, untouched by history, a soul stirring its wings within that stiff sarcophagus […] a creature left over from an earlier age, like a coelacanth or the last man to speak Yaqui” (151). The medical officer realizes K’s condition lies beyond simple diagnosis; rather, K’s body craves “a different kind of food, food that no camp could supply” (163). Sometime in the night, K vanishes from the hospital with his packet of pumpkin seeds, moving toward another remote patch of earth to cultivate.

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When She Hollers

Voight, Cynthia

Last Updated: Sep-21-2013
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel for Young Adults

Summary:

Tish brings a knife to the breakfast table and threatens to use it on her stepfather if he tries to come into her room again.  Her mother, working at the sink, does her best to ignore the conversation, in which the stepfather moves from mockery to threats.  Tish carries the knife in her boots to school.  When her gym teacher insists on her removing her boots she begins to scream uncontrollably, is sent to the principal, and, unable to tell her secret, runs away.  She finally makes her way to a friend's father, a lawyer, who listens to her story and assures her of legal protection, though as the story ends, Tish has a lot of decisions left to make, and a long way to go before she feels safe and healed.

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Annotated by:
Sirridge, Marjorie

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

This is a story of the interactions of an art student and her assigned mentor, with whom she is at odds, and the interactions of the mentor with a university professor who has been given the task of arbitration between the student and the mentor. The problem for the student and the mentor is that they have totally divergent views of Matisse as a painter of women's bodies.

The mentor sees these paintings as beautiful but they are abhorrent to the student, who has developed an eating disorder as part of her rebellion against the emphasis on female pulchritude. The painting "La Porte Noire" is used to describe the mentor's great admiration for Matisse's amazing use of color.

The university professor brings to the encounter with the mentor her astute understanding of the problem, but also some of her personal issues; this interaction includes a subtle description of the many possible reasons for suicide attempts. The story skillfully describes academic conflict, unhealthy human behaviors, and the importance of skillful arbitration.

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The Fat Girl

Dubus, Andre

Last Updated: Oct-09-2012
Annotated by:
Donley, Carol

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Fat Louise, with an eating disorder since she was nine, would diet in public and sneak candy and peanut butter sandwiches in private. Her parents pitied her and were embarrassed by her. Her college roommate caught her at the secret eating and offered to help her get control of her eating. The diet and exercise ritual, combined with smoking, brought her weight down 60 pounds and made her beautiful and eligible to be married. Her parents were proud. She got married. But often she felt "no one knew her"--that she really wasn't this slim 120 pound beauty.

Then during her pregnancy she lost the discipline and ate compulsively and secretly. After the baby was born she continued to eat--her husband disapproved and didn't want to touch her, her mother scolded. The marriage, based on appearances, started to fall apart; she looked forward to being alone with her child and able to eat anything she wanted without other people judging her.

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To Be Mona

Easton, Kelly

Last Updated: Sep-03-2010
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel for Young Adults

Summary:

As the story opens, Sage Priestly, 17, is running for class president against Mona, whose popularity Sage finds both threatening, fascinating, and a matter that keeps her in a state of uncomfortable envy. In her efforts to "be Mona," Sage undertakes a drastic diet, changes her haircolor, and focuses all her leisure dream time on Roger--a boy she can't see is incipiently abusive, though her long-time friend, Vern, loves her in a healthy and faithful way--a love that is tested when Sage starts dating Roger and suffering actual physical abuse.  As we learn about her troubled social life, we also learn that at home Sage is a caregiver for her single mother whose bipolar disorder  and depression pose a huge and confusing challenge to the teenage daughter.  Vern's parents eventually intervene to help both Sage and her mother get appropriate care and oversight, and Sage begins to recognize in Vern (and his gay friend Walter, who has suffered his own social challenges) the kind of friend that will last.  The book includes an afterword in which the author provides a note from personal experience on bipolar disorder (one of her parents was bipolar) and abuse, and lists helpful resources. 

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Less Than Zero

Ellis, Bret

Last Updated: Jul-30-2010
Annotated by:
Henderson, Schuyler

Primary Category: Literature / Fiction

Genre: Novel

Summary:

19 year old Clay has returned to Los Angeles for the Christmas break, his first time back after leaving for a Northeastern college.  He spends the next month meeting with his clique, going to parties and restaurants, visting a friend hospitalized for anorexia, lying on his bed at home and joining his family at the mall or for dinner.  As Clay and his friends are the progeny of LA's wealthiest, this typical return-from-college-for-the-Christmas-break story also entails driving expensive cars, steady drinking, constant smoking, copious amounts of cocaine and marijuana, and frequent sex (gay, straight; voluntary, paid-for).  Dulled by drugs and boredom, these teenagers are drawn to excesses to jolt them out of their expensively-maintained ruts: to prostitution and snuff films, to dead bodies in the street and, ultimately, to sadistic child abuse.

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