The First Wave

Heineman, Matthew

Last Updated: Apr-18-2022

Bruell , Lucy

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

First Wave documents the early days of the COVID-19 pandemic at Long Island Jewish Medical Center (LIJ) in New York from March through June of 2020. It opens with a graphic scene of a rapid response team trying to save a patient with COVID whose heart has stopped. Despite their efforts, the patient dies. After the team pauses for a minute of silence at the bedside, the grueling work of saving lives continues.

The film follows Dr. Nathalie Dougé, an internist who was born in the Bronx to Haitian parents. Most of her patients are Black, Hispanic or immigrant. Two patients with COVID are essential workers: Brussels Jabon, a Filipino nurse who undergoes an emergency C-section after she is brought to the emergency room, and Ahmed Ellis, a school safety officer with the NYPD. Both have young children and supportive families.

Nurses hold up IPads so families can Facetime with the patients. It’s terrifying and sad for the families to see the patients on screen and not to be present when they are needed the most. It’s emotionally difficult for the healthcare team as well who are the only ones to hold a patient’s hand during these encounters. One nurse describes the effect of holding the phone while family members have five minutes to Facetime with patients, “You become the family member, and it seems like you’re losing your family.”

The emotional toll of losing so many patients, while fearing that they too may contract the virus and bring it home to their own families, weighs heavily on the healthcare teams. They are trained to compartmentalize, to separate work from personal life but their empathetic response to their patients follows them home. “I think about him every night when I go home,” nurse Kelli Wunsch says of Ahmed. “I just want him to do well.”

Scene after scene of teams rushing to resuscitate a patient who has coded are interspersed with more hopeful moments of a reunion between husband and wife, the sound of the song “Here Comes the Sun” when a patient is taken off the ventilator, and the cheerful encouragement of a physical therapist working to help a patient regain enough strength and mobility to be discharged. At times the camera moves outside the confines of the hospital to the outside world: Dr. Dougé alone at home with her dog celebrating her birthday with friends over zoom, eerily empty streets during the lockdown, and families anxiously awaiting news from the hospital. We see bodies taken to refrigerated trucks and people cheering the health workers at 7pm from windows across the city.

In May, when protests erupt following George Floyd’s murder, Dr. Dougé, joins the protest with other frontline workers carrying a sign, “Racism is a Public Health Issue” and ”I Can’t Breathe” scrawled on her surgical mask. Amid the “I Can’t Breathe” cries of the protestors, she relives the myriad times she has heard her patients gasping those words to her just before they are placed on ventilators.

Both Brussel and Ahmed become stable enough to be taken off the ventilator and released from the hospital to return home to their families. Despite their recovery from the acute phase of the illness, it is clear their health remains severely compromised. As the cheers of the staff in the hospital lobby fade, tough work lies ahead for these patients and their families.

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Fauci

Hoffman, John; Tobias, Janet

Last Updated: Mar-14-2022

Yin, Ellen
Salman, Akbar

Primary Category: Performing Arts / Film, TV, Video — Secondary Category: Performing Arts /

Genre: Film

Summary:

“The Jesuit philosophy is ‘Men for Others,’” states Dr. Fauci, the titular subject of the documentary Fauci, as he explains how his public school experiences informed his medical career. Indeed, it sets the tone for the rest of a film that traces the beginning of Dr. Fauci’s career as an infectious disease physician through to his role in the creation of PEPFAR, the 2014 Ebola outbreak, and his present day responsibilities in the current pandemic. The documentary bounces primarily between the 1980s HIV/AIDS epidemic and the start of the COVID-19 pandemic in 2020. In both, we see that Dr. Fauci stands as a figure of great controversy, and we are shown his thought process in navigating the court of public opinion.

The film starts off interviewing Dr. Fauci about his childhood in Bensonhurst, Brooklyn where he was exposed to the Jesuit philosophy that would dovetail with his choice to go into public health service when he was drafted into the Vietnam War. Though he began his medical career with aspirations for a private practice on Park Avenue, Dr. Fauci realized that his true calling lay in “trying to figure out diseases that people were dying from” at the National Institute of Allergy and Infectious Diseases where he soon faced one of the greatest public health challenges of the 1980s – piecing together a way to combat a mysterious new disease that was killing more and more Americans.

This, of course, sounds very familiar to the intended audience of the documentary. It is a parallel that Dr. Fauci himself is well aware of, stating that COVID-19 feels like a “diabolical repeat” of his experiences in the 1980s but that “the difference is [the] divisiveness dominating COVID-19 . . . we’re going to get through it in spite of this divisiveness and this politicization. We’re not going to get through it because of it.” The film leans heavily into this contrast, showcasing the evolving attitudes of many AIDS activists as Dr. Fauci went from “the enemy” to a man sitting in on ACT UP meetings and engaging in a dialogue that would culminate in a historic address at the 1990 International AIDS Conference – an address that highlighted the need for physician-scientists to incorporate the feedback of the individuals they were trying to help and reminded activists of the compassion that physician-scientists have for their patients.

In the scenes taking place in 2020, we see an explosion of both positive and negative press coverage of Dr. Fauci as the COVID pandemic kicks into high gear. His inconsistencies regarding mask guidance, his direct challenging of President Trump, and his struggle to deal with increasing death threats against himself and his family are put on full display. The documentary does not shy away from showcasing Dr. Fauci’s vulnerability with multiple instances of a tearful Fauci recounting the deterioration of many of his AIDS patients and the “post-traumatic stress” that those experiences induced. These moments of vulnerability are threaded in with images of and commentary from his wife Christine Grady and his daughter Jennifer, a clear attempt to give us a sense of Anthony Fauci the human being and not just Dr. Fauci the public servant.

As the film draws to a close, Fauci and his wife take a walk through the COVID-19 Memorial on the National Mall in Washington DC. “When you're involved in a race to stop a horrible disease, you always feel like you’re not doing things quickly enough, or well enough,” he reflects. “One of the most mysterious aspects of our universe is how viruses have transformed our civilization . . . And the one thing I can hope for . . . is that emerging infections do not inevitably become pandemics . . . I am optimistic that the lessons that we’ve learned will prevent that from happening.” After watching this documentary, it is an optimism that is easy to share.

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Bewilderment

Powers, Richard

Last Updated: Dec-20-2021

Trachtman, Howard

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Science is a fundamental part of modern reality. It is used to explain the workings of the world around us and is instrumental in making that world a more hospitable place to live in. There are those who assert that there is a fundamental conflict between science and religion. They advocate considering science and religion as parallel but not intersecting ways to understand the place and purpose of human beings. What about science and art? Or science and literature? Can they peacefully co-exist? Richard Powers is an author who has dedicated his literary career life to the proposition that they can.

In his latest book, Bewilderment, he examines the question whether neurobiology can help people achieve empathy, potentially even merge with another person. Theo is an astrobiologist, someone whose job is to explore the conditions on the many planets in the universe and to determine if they are able to support any form of life, but especially human life. The underlying premise is that there are bacteria, fungi, and animals that can live under very extreme circumstances on Earth. So even if other planets have different atmospheres, ambient temperature, water, or chemical elements, Earth should not be the only planet with life.

Theo’s wife, Alyssa, has recently died in a car accident and he is still grieving the loss. She was pregnant at the time, and the accident occurred when she lost control of her car when trying not to run over an animal on the road (more on this in a minute). Theo has one son, Robin, who is very bright but on the autism spectrum with significant anger issues. The father and son are fiercely connected and share their lives; the early part of the book beautifully describes a camping trip that they take together. But Theo has his hands full with Robin. In order to avoid medicating his son, Theo enrolls him in an experimental program, Decoded Neurofeedback (abbreviated DecNef, like any DARPA-sounding program). The experimental study will enable Robin to control his emotions better. This would be accomplished by capturing his mother’s brain waves in a functional magnetic resonance imaging (fMRI) scanner. The pattern of her neural activity, which reflected her intense love of animals and nature, would provide a template that could be channeled into her son using feedback methods. The objective of the experiment is to convert Robin into a more sensitive child who is more attuned to the world around him. Robin is remarkably responsive to the sessions, more so than any other participant, and he becomes someone who has the same warmth and protective feelings towards animals and the environment as his mother. But funding for the project is terminated, Robin’s fMRI sessions stop, and he gradually reverts back to the child he was. There is a final twist. But I leave that to those who are motivated by this annotation to read the book.

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Practice

Berlin, Richard

Last Updated: Oct-26-2021

Kohn, Martin

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

Practice is Richard Berlin’s third book of poetry (two of which are chapbooks) in addition to two prose books. It contains 64 poems and is fronted by an essay, “Why Doctors Need Poetry”. A few pages of notes at the end helpfully explain the context for 15 of the poems. As Dr. Berlin explains at the beginning of his opening essay: “Most of the poems in this volume first appeared in my column, ‘Poetry of the Times,’ a feature of Psychiatric Times”, which, at the time of publication of this volume he had been writing for 16 years. This—and many more poems in other journals, anthologies, and books— all from a man who began writing poetry in “mid-life”. Evident in the poems in this collection is a person experiencing much more than medical/psychiatric practice, but a full cornucopia of life: his love of art, music, food, nature, and the people he shares this bounty with. The collection, presented in three sections, weaves through all of these rich encounters, with only the final section, the shortest of the three, having more of a focus on family, friends and late of the year poems.

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Freud on My Couch

Berlin, Richard

Last Updated: Aug-11-2021

Davis, Cortney

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Secret Wounds

Berlin, Richard

Last Updated: Aug-06-2021

Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

In Secret Wounds, his second full length collection of poetry, psychiatrist Richard Berlin continues his exploration of the inner world of medicine with a sequence of 73 poems that flow seamlessly, uninterrupted by grouping into topics or sections. In the first poem, “Lay Down Sally,” the author attends a man dying on dialysis, and concludes with “A nurse hangs the morphine. / I write my blue notes.” In the last, “The Last Concert of Summer,” he reflects on his long experience with the sick and suffering, ending the poem with, “I place a stethoscope in my ears and listen / to the heart when I’ve run out of things to say.” In between, the poems reflect varied incidents, topics, conflicts, and wounds, as they occur from medical education (“Teaching Rounds,” “Touch,” “On Call, 3 AM”) through a life in medical practice (“Rage,” “The Scientists,” “How a Psychiatrist Parties”) to something like enlightenment (“Note to Pablo Neruda,” “A Psychiatrist’s Guitar,” “End of Summer”).

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The Empathy Exams

Jamison, Leslie

Last Updated: Aug-02-2021

Zander, Devon

Primary Category: Literature / Nonfiction

Genre: Collection (Essays)

The Ministry of Bodies

O'Mahony, Seamus

Last Updated: Jul-26-2021

Miksanek, Tony

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Starting eight months before his retirement, a gastroenterologist chronicles a myriad of encounters between himself and others - patients and their family members, colleagues, administrators, hospital staff, and even drug reps. He has worked for many years at a large Irish hospital dubbed the "ministry." His professional work there is divided between the endoscopy unit (where he performs colonoscopies and EGDs), medical wards, an outpatient clinic, and the ER.

Given his specialty, the roster of patients tilts heavily towards gastrointestinal problems: alcoholic cirrhosis, GI bleeding, chronic diarrhea, and abdominal pain. But additionally, his days are filled with patients presenting with a variety of medical problems including pneumonia, mental health issues, heart failure, serious fractures, dementia, seizures, anemia, and cancer. He attends to many frail elderly folks in the emergency department. His interactions with patients range from intense to jovial, from unexpected to heart-wrenching. For example, a woman with chronic abdominal pain asks the doctor if she might be suffering from PTSD. When asked why she thinks that might be possible, her reply is "My son hung himself. I found him" (p191).

The doctor is beleaguered by frequent, and at times wacky, emails generated by the hospital bureaucracy as well as unproductive meetings. He must cope with his own health problems too (a vitreous detachment, arthritic hands, and unexplained nosebleeds). He decries the "foolishness" of excessive medical testing and overtreatment and cites the case of a young woman with irritable bowel syndrome who already had over 1,200 test results logged in the hospital lab. He describes the ministry as "an oasis of kindness and comfort" but "also a place of chaos and conflict, of institutional cruelty" (p8).

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Camouflage

Nisker, Jeffrey

Last Updated: Mar-19-2021

Duffin, Jacalyn

Primary Category: Literature / Plays

Genre: Play

Letter to a Young Female Physician: Notes from a Medical Life

Koven, Suzanne

Last Updated: Feb-26-2021

Miksanek, Tony

Primary Category: Literature / Nonfiction

Genre: Collection (Essays)

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).

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