Summary:

Thin, a documentary film produced, aired and distributed by HBO, is the centerpiece of a multi-faceted project that explores the complex issues of body images and eating disorders in young women. Photographer and journalist Lauren Greenfield began documenting eating disorders in 1997, eventually publishing an article for Time Magazine and a book entitled Girl Culture, as well as producing a traveling photographic exhibit. Returning to one of the facilities featured in the exhibit, Greenfield took up residence at the Renfrew Center, an in-patient facility for eating disorders in Florida, to film the day-to-day suffering of four young women struggling with anorexia over the course of six months.

The youngest is Brittany, a sad and troubled fifteen-year old, whose bulimia and anorexia began when she was only eight (her weight bounced from 185 to 95 pounds in one year) and whose mother has her own very unhealthy relationship to food. Brittany is eventually returned to her weight-obsessed mother because of the loss of insurance. Shelly, a twenty-five year-old, psychiatric nurse, has been anorexic for six years and enters Renfrew at 84 pounds with a surgically-implanted feeding tube. Her identical twin visits to plead with Shelly to refrain from slowly killing herself and ultimately destroying their family. Polly is a twenty-nine year old, charming troublemaker whose health is returning but whose defiance of rules eventually gets her kicked out of the facility. The oldest patient is Alisa, a thirty-year old, divorced mother of two whose eating disorder ostensibly developed at age seven when a pediatrician persuaded her mother to put her plump daughter on a severe diet. Alisa's graphic account of a single day of binging and purging is shocking, and her forced release from Renfrew because of problems with health insurance precipitates a return to this pattern after she tucks her children into bed.

 

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The subtitle to this collection of insightful and compassionate essays by gastroenterologist David Watts is: "One Doctor's Reflections on the Oddly Intimate Encounters Between Patient and Healer." Watts provides 48 narratives, most of which concern his patients and are written in the first person. In the preface Watts states "The stories in this book are true" (xv), that he has received permission from his patients, and that he has "disguise[d]" his patients to respect their right to privacy.

The stories cover a range of settings, from Watts's home and locations in the San Francisco Bay area, to the clinic and hospital. They also cover a range of his experience from medical school ("Sylvester" and "Love is Just a Four-letter Word") to his current position as a practitioner and an attending physician at a teaching hospital.

Stories in which Watts clearly situates himself with the patient and details the encounter are most compelling. For example, in the opening essay, "White Rabbits" and later, in "Flu Shot," Watts allows the reader to discover that patience and listening are required to in order for the patient to expose why he or she is truly there. In that space, Watts becomes present for his patient, and one learns that what may initially appear tangential is central to the patient's concern.

Watts writes of some very difficult patients and families, such as a woman who stalks him ("The Stalker's Bridegroom"), a woman who obsesses over caring for her elderly mother ("Home Remedy"), and a woman who demands narcotics ("The Third Satisfaction"). In one of the longer pieces, "Codger," Watts describes an irascible, elderly Jewish patient who skewers just about anyone with his critiques, including Watts's young son, and yet who later exposes his vulnerability by unfolding the tale of his World War II service and discovery of a Nazi death camp. It is because Watts spends time with the Codger and recognizes that the doctor-patient relationship is above all a human relationship that the doctor receives the gift of the story: this terrible experience which informed the rest of the Codger's life.

A few of the vignettes explore the therapeutic potential of poetry. For instance, in "Annie's Antidote" a piano teacher, fearful of endoscopy, asks Watts to recite one of his poems. The poem concerns the tender relationship between Watts and his son and is a metaphor for Watts's patient encounters as well: "for this is one of those moments / that turns suddenly towards you, opening / as it turns, as if we paused / on the edge of a heartbeat. . . " The poem works, the moment opens, and the woman has her endoscopy.

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Summary:

This remarkable collection of short writings, introduced by renowned poet Naomi Shihab Nye, who visited the Sutterwriters (of Sutter Hospital in Sacramento, California) to offer a workshop, provides a broad, compassionate, imaginative window into the life inside and around an urban hospital. Patients, staff, and all interested in healing through writing are invited to come and participate-with an accent on the latter: no one is invited who isn't willing to write.

Chip Spann, the editor, came to Sutter Hospital with a Ph.D. in English, and has the privilege of coordinating this fluid community of writers as part of his work as a staffmember. His conviction, voiced in an engaging introduction, is that literature is a powerful instrument of healing--both the literature we read and the literature we create--and that the experience of literature belongs in community. The individual pieces are accompanied by photographs and short bios of contributors.

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This is a collection of 91 poems on medical topics by medical students, physicians in training, and attending physicians; two are Canadian and the rest American. The poems are organized by six traditional groups of medical training and advancement in the profession: Medical Student, First Year; Medical Student, Second Year, Medical Student, Clinical Years; Intern; Resident; and Attending. There are no sections for pre-meds, retired doctors, or other programs (naturopath, chiropractor).

The editors have done a good job of picking well crafted and evocative poems. A dozen have been previously published. For the most part, the poems are short, easily fitting on one page. Almost all are in free verse, although there is one group of haiku, one prose poem, and an impressive sequence of ten Shakespearean sonnets “Breughel at Bellevue” by Anna Reisman.

Many poems treat dramatic moments in training: the anatomy lab, first gynecological exams, physician-patient relationships, especially when a patient is gravely ill or dying. Several poems in the first three sections comment on the differences between the normal social world and the intense medical world of the hospital. Throughout there are references to the pressures of high-tech, unfeeling medicine. Indeed Jack Coulehan sounds this theme in his introduction; he writes that "steadiness and tenderness" are both needed in medical practice.

 

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Jeff is happily connected to his beautiful girlfriend, Norma, a skilled potter and social success, when "the fat girl," Ellen, enters their pottery class. Finding himself despising her, Jeff feels responsible when one day she overhears his mean remarks about her fat, her awkwardness, and her incompetence. Attempting to atone for his behavior, he visits her at her home and finds himself involved in more than he anticipated when she confides that she is considering suicide.

For reasons he himself doesn't understand until much later, he gradually becomes both friend and caretaker and, as she loses weight under his guidance, a possessive and supervisory boyfriend. Ellen's transformation eventuates in a new sense of her own worth and objectives, and also in a startling confrontation with the boy from whose help she also has to break free.

Readers are left to ponder the implicit connection between Jeff's controlling behavior toward his girlfriend protégé and his ambivalent relationship with a mother whose reaction to divorce has been to control her children in ways that entrap them. Both the protagonists learn valuable and also very painful lessons.

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Sultana, a doctor who escaped her illiterate nomadic background to study and work in France, returns to her native Algeria when she hears of the death of her former lover and fellow physician, Yacine. She is treated with hostility, but defiantly stays in Yacine’s place at the clinic. Vincent, a Frenchman who is the baffled recipient of a perfectly matched kidney from a young Algerian woman, travels to the desert to explore the culture of this unknown person whose death has brought him back to life.

Sultana and Vincent meet through their common friendship with the furtive, questioning children, Dalila and Alilou. Vincent and Salah, Yasmine’s best friend, both fall in love with Sultana, but she seems indifferent to them. The violence and suspicion of the town leaders causes her to regress into anorexia and mutism, during which she is tormented by the horrible memory of the loss of her parents. Her three male friends and the village women help her to recover a sense of self worth, but she must flee when the leaders set fire to their dwellings. A glimmer of optimism can be found in the aspirations of the children and the solidarity of the women.

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This is an essay from Patricia Foster's collection, Minding the Body: Women Writers on Body and Soul. The narrator describes her startling reversal to shame over her thin body as she sits in a women's bath house in Morocco with her Moroccan friend, shocked by the discovery that she was not completely at ease with the shape of her body, having thought she'd gone well beyond that stage.

Growing up in a culture that viewed thinness the way modern U.S. culture views fleshiness, the narrator describes her strong sense of unworthiness and disgrace and the jealousy she felt for the "ripe, round cheeks of the other girls, and their chubby arms and legs." Now more comfortable in her body, she is still struck by the ancient standards of beauty--thin or heavy--that are decreed by men. In this Moroccan bath, plumpness means that "women still stick to the rule that says that the male eye is the only mirror where [women] can see their true reflection."

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Subtitled Women Novelists of Color and the Politics of Medicine, this book draws on novels by eleven women to illustrate how physical and emotional states of health and illness are linked directly to social justice. The book is divided into two parts. The first five chapters deal with individual characters, their illnesses, and sometimes their healing: Toni Cade Bambara's The Salt Eaters, Paule Marshall's Praisesong for the Widow, Gloria Naylor's The Women of Brewster Place: A Novel in Seven Stories, Leslie Marmon Silko's Ceremony, Toni Morrison's Beloved and The Bluest Eye, Louise Erdrich's Tracks, and Sapphire's Push are among the works Stanford uses to examine women who have become ill because of broken ties to their histories and communities, because of racial hatred, or because of domestic and sexual violence (see this database for annotations).

The second part of the book finds novels examining medicine itself. Stanford uses Ana Castillo's So Far from God, Gloria Naylor's Mama Day (annotated in this database), Leslie Marmon Silko's Almanac of the Dead: A Novel (annotated in this database), and Octavia Butler's Parable of the Sower and Parable of the Talents again to raise connections between patients and social conditions but also to ask questions about bioethics and uncertainty, medicine and epistemology, and how medicine might resist dehumanizing trends through the "myriad possibilities of communitas" (218).

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Something is wrong with Billie Weinstein's older sister, Cassie, now in her first year at Cornell. She has given away all her clothes except an old sweatsuit and blue jeans. She studies obsessively, convinced she's failing despite a stellar academic record. She rescues food and paper products from the garbage, unable to bear seeing anything wasted. And she's losing weight dramatically.

Even though their father is a doctor, it takes the family several months to recognize and acknowledge all the classic symptoms of anorexia and get Cassie to a psychiatric hospital. In the meantime Billie, still in high school, divides her energies between worrying about her sister, coping with an overbearing father, and finding her way in a relationship confused by sexual pressures and ethnic differences.

Her best friend's large, close, messy, jovial Italian family offers her a refuge from her own much less expressive one, but she discovers they have their own stresses, mostly financial, which drive them suddenly out of town in a moment of crisis. So it's a year of loss, transition, and rapid maturing for Billie, who finds, when her sister comes home with an uncertain prognosis, that she can no longer be the "baby," but has assumed a new, more responsible place in the family system and a new authority over her own life, defined in terms that have less to do with her sister, and more with her own desires and purposes.

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Lara Ardeche, a glamorous sixteen-year-old, is elected homecoming queen at her Nashville high school, as her mother was years before. She works out daily on gym equipment supplied by her wealthy grandfather. She thinks her family is perfect: her mother and father are youthful and attractive, her younger brother is cute and smart, and she is popular, beautiful, and her father's "princess." Her best friend, Molly, is one of the few offbeat characters in her life; other friends call Molly "the Mouth." Molly is frank, funny, a little fat, and indifferent to the unsubtle slurs of the in-crowd.

Weeks after homecoming, Lara, who has never had a weight problem, begins to gain weight rapidly and inexplicably. Within months her weight soars to 200+ pounds. She is diagnosed with a rare "Axell-Crowne" syndrome, a severe metabolic disorder with no sure cure. Most of her friends abandon her, though Molly stays faithful and Jett, Lara's boyfriend, tries to maintain a relationship.

The family begins to fall apart. The father, it turns out, has been having an affair. They move to Michigan to get a "new start." But the affair continues, kids at the new high school are cruel, and Lara is miserable until she is introduced to a new, motley group of people through her piano teacher who shares her love of music and is about her size.

In a cross-generational, racially mixed jazz club she begins to think differently about who she is and on what basis real relationships survive. By the time her weight begins slowly to fall, she has come to terms with herself and the dysfunctions in her family in a whole new way, and at great cost. She still hopes to be thin again, but not because she any longer kids herself that a fashionably thin body is a key to happiness.

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