Showing 11 - 20 of 406 annotations tagged with the keyword "Mental Illness"

Practice

Berlin, Richard

Last Updated: Oct-26-2021
Annotated by:
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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Everything is Fine

Granata, Vince

Last Updated: Oct-03-2021
Annotated by:
Glass, Guy

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Vince Granata, the author of Everything is Fine, remembers feeling at the age of 4 that the day his triplet siblings were brought to their suburban Connecticut home from the hospital was the best day of his life.  For many years, to all appearances, his was the perfect family.   

Then, while in college, his brother Tim develops a psychotic disorder.  Refusing treatment, he becomes more and more delusional.  He speaks frequently about killing himself and is convinced his mother has raped him.  Announcing that “demons are everywhere” (p.115) he enters his parents’ bedroom and throws salt at them as they sleep. His mother, though trained as an emergency physician, dismisses the idea he could become violent: “Everything is fine” (p.122).  

When Vince receives a phone call that his brother has killed his mother, he rushes home from teaching abroad to find yellow tape surrounding the house.  The immediate, surrealistic concern is to have a company clean the traces of his mother from the rug.   

Over the next few years, Tim is treated to restore him to competency so he can stand trial.  Vince and his father visit Tim faithfully in a facility while two other siblings cannot bring themselves to face him.  A friend insightfully prophesies “I hope you will eventually be able to find some peace and feel whole again…though that might be your life’s work” (p. 149). Indeed, while his brother recuperates, Vince goes through his own healing process. He dedicates himself to understanding schizophrenia and the shortcomings in our mental health care system, and, finally, writes this book.  

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Secret Wounds

Berlin, Richard

Last Updated: Aug-06-2021
Annotated by:
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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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.  

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Annotated by:
Donley, Carol

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

 Cortney Davis has divided this collection of her poetry into seven major sections which she calls “Voices.” The first and last sections are “Voices of Healing” which frame and wrap around the others: “Home,” “Desire,” “Suffering,” “Faith,” and “Letting Go and Holding On.” The sections include previously published poems as well as new ones.  Davis is known for her ability to see and understand what is going on and to express that in ways that help the reader “get it.”  This collection also shows her ability to hear the unique voices that express suffering, faith, desire—and to convey empathic understanding of the speaker.  Sometimes she gets angry with the speaker. The poems range through time, from her childhood, nursing training, nursing experiences, deaths of her parents, to more current experiences with grandchildren.  Throughout there is a consistent caring and compassion, mixed with many other feelings, many of them contradictory.

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The Winter Soldier

Mason, Daniel

Last Updated: Jun-20-2020
Annotated by:
Field, Steven

Primary Category: Literature / Fiction

Genre: Novel

Summary:

When The Winter Soldier opens, Lucius Kszelewski, youngest son of a patrician Polish family living in Vienna, is on a train bound in the dead of winter for a field hospital in the Carpathian Mountains.  It is 1915, and Austria-Hungary is at war with Russia.  Lucius, a medical student, has completed only six semesters of medical school, but World War I has intervened, and due to a shortage of physicians in the army the government has decreed that students may graduate early, become doctors, and immediately be commissioned.   Lucius has done so and is on his way to Lemnowice, a Galician village, where he believes he will work with other physicians and finally learn to be “a real doctor.” 

When he arrives, he finds that the hospital is an expropriated village church overrun by rats and ravaged by typhus, and he is the only physician.  The hospital is run by a nun, Sister Margarete, assisted only by orderlies, and the patient load runs the gamut from fractures and gunshot wounds to gangrenous legs and massive head trauma.  The front is only a few kilometers away, and the wounded arrive continuously; the quiet and formal Sister Margarete confidently and  surreptitiously guides him through rounds, surgeries, and battlefield medicine.  Lucius is initially wary of her, perhaps a bit awed by her, and ultimately falls in love with her.    

The transforming event is the arrival of the winter soldier, Jozsef Horvath, brought in from the snow mute and shell-shocked, but with no visible wounds.  Lucius is fascinated by diseases of the brain and mind, and this patient presents a tremendous challenge.  Lucius is sure that Horvath has “war neurosis,” what the British physicians of the time were calling shell shock and what we today would call PTSD, and he is determined to understand and heal him.  Lucius and Margarete make slow progress with their patient, but his attempts to care for Horvath have unintended effects, and Lucius must then deal with the consequences of his actions.  

The war, and the hospital routine, go on.  One day, while Lucius and Margarete are relaxing in the woods, Lucius asks her to marry him.  Margarete runs off, and Lucius returns to the village, but Margarete is not there.  While Lucius and the staff search for her, Lucius gets lost; he stumbles onto a battlefield and is dragooned into service with a regiment of the Austrian infantry.  He escapes and tries to make his way back to the field hospital, and to Margarete, but Lemnowice has fallen to the Russians.  The hospital has been evacuated—and Margarete has disappeared.   Lucius’ search for her will take him across the war-torn remnant of the Empire.

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Hidden Valley Road

Kolker, Robert

Last Updated: Jun-15-2020
Annotated by:
Glass, Guy

Primary Category: Literature / Nonfiction

Genre: Biography

Summary:

The Galvins of Hidden Valley Road, just outside Colorado Springs, appear to be the kind of wholesome, all-American family that others might envy.  The tragic fact is that six of the twelve children go on to develop schizophrenia, a situation that is practically unprecedented.  In Hidden Valley Road, journalist Robert Kolker gives us the tale of the deterioration of six afflicted children and the traumatization of six healthy ones in an improbable, bucolic setting.  As one after the other reaches young adulthood in this “funhouse-mirror reflection of the American dream” (p. xxi) and inexorably succumbs to madness, the family struggles to cope.   

In their search for answers, the Galvins’s extraordinary circumstances come to the attention of researchers.  Ultimately, although there is no cure, the family makes a contribution through their genes to our understanding of schizophrenia, as a mutation is discovered that is shared by the afflicted children.   

Hidden Valley Road follows the travails of this “multiplex schizophrenia” family over so many years that there is a sea change in our understanding of the disease’s origins.  At first, it is taken for granted to be the result of a faulty upbringing at the hands of “schizophrenogenic” parents.  Later, biological explanations prevail.  Finally, a more balanced view is attained, with nature and nurture each thought to play a role.  

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The Eye in the Door

Barker, Pat

Last Updated: Jun-08-2020
Annotated by:
Field, Steven

Primary Category: Literature / Fiction

Genre: Novel

Summary:

The Eye in the Door is the second volume in Pat Barker’s Regeneration trilogy (the first and third volumes, Regeneration and The Ghost Road are also annotated in this database).  It continues the story of Dr. William Rivers and the soldiers he treats for shell shock, what we today would call Post-Traumatic Stress Disorder, in World War I era Britain.  The action has now shifted from Craiglockhart War Hospital, near Edinburgh, to London; and while Rivers remains a primary character, seeing patients now at a London clinic, this volume focuses on Rivers’ relationship with Billy Prior, an officer who was treated at Craiglockhart after a service-related nervous breakdown. 

Billy Prior, released from service on the Front and now serving on “home duty,” is working in the Intelligence Unit of the Ministry of Munitions, a domestic information-gathering and surveillance unit.  England, on wartime footing, is rife with paranoia and conspiracy theories, and the primary objects of state surveillance are two groups of people felt to be disloyal or untrustworthy:  conscientious objectors, or “conchies,” and homosexuals, who are seen as both abnormal and subversive.  The state is unremitting in its hounding and pursuit of these two groups, and is in fact “the eye in the door,” always watching and ready to pounce. 

Although Billy is an officer and has a position in the surveillance apparatus, he is living a double life, and is doubly at risk in this environment.  He is bisexual; the book opens with him failing to complete the seduction of a young woman and promptly thereupon having a liaison with a fellow officer whose wife and children are out of town.  This officer, who also works in the Ministry, has been vaguely threatened about his association with the presumed network of homosexual subversives.   In addition, while Billy is not a pacifist, he has friends from his childhood in working-class northern England who are conscientious objectors.  These friends may or may not have participated in terrorist activities, are either currently in jail or wanted by the police, and are no surer than Billy is as to exactly whose side he is on.  

Prior plays a dangerous double game, attempting to use his position in the government to help his old friends, and continuing treatment with Dr. Rivers, as his past psychological traumas continue to intrude upon, and complicate, his personal and professional lives, building to a powerful conclusion.

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The Ballad of Typhoid Mary

Federspiel, J. F.

Last Updated: Apr-07-2020
Annotated by:
Belling, Catherine

Primary Category: Literature / Fiction

Genre: Novel

Summary:

The novel's narrator is a widowed 58-year-old Swiss-born physician, Howard J. Rageet, who lives in New York City. His son is a pediatrician, his daughter a medical student. Rageet himself is terminally ill. He is writing a "little biography," of Mary Mallon, the infamous "healthy carrier" also known as Typhoid Mary. Rageet's grandfather, also a doctor, had kept a journal about Mary and his rivalry with his friend, (the real) George A. Soper, whose life's work became tracking Mary and proving that she was responsible for the typhoid outbreaks. Elaborating on the journal, Rageet recounts Mary's life in America.

Born Maria Anna Caduff in the same part of Switzerland as Rageet's ancestors, she arrives in New York Harbor in 1868, aged 13, on a crowded immigrant ship, a fifth of whose passengers had died en route from Europe. The dead include Mary's family. She had been taken care of by the ship's cook, who evidently both taught her to cook and used her for sex. When the ship docks, Mary tries to jump overboard, but is stopped by a physician, Dorfheimer, who smuggles her through Ellis Island and takes her home with him. He is also a pedophile, and he has sex with her. Rageet calls this kidnapping a "humane, benevolent crime." Not long after, Dorfheimer dies of typhoid fever.

Rageet's "ballad" then traces Mary's various positions as a cook (and, often, sexual object), most of which end quickly when the household is infected. She has two relationships that do not lead to the disease. One is with a small girl who has Down Syndrome. Once her connection to typhoid is suspected, the child's family hire Mary to live alone with the child and care for her, hoping the child will be infected and die. The child never becomes ill. The other is with a disillusioned anarchist, Chris Cramer. She lives with him and falls in love with him, but he is not sexually interested in her.

Soper encounters Mary when he is asked by a wealthy Oyster Bay family, her former employers, to investigate a typhoid outbreak in their household. He manages to track her down and eventually, after much resistance, she is arrested, tested, and quarantined. She escapes and continues to work as a cook until her re-arrest. Promising to try and imagine Mary's motives, Rageet breaks off his narrative. He is dying. The novel ends with a postscript written by Rageet's daughter. Implying that her father committed suicide, she tells of Mary's stroke and the last years of her life as a paraplegic, and she provides a final document, the menu for one of the very elaborate meals Mary would have cooked.

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Summary:

A dramatic prologue depicts Joan Kleinman screaming and hitting her husband Arthur in bed. She is ill with Alzheimer’s disease and does not, for that moment, recognize him. The following chapters provide a long flashback, beginning with Arthur’s family background, his youth as a tough street kid in Brooklyn, his medical education, and his marriage to Joan. We learn of their work in China, travels, and professional success. Arthur gradually realizes that the US health care system has become “a rapidly fragmenting and increasingly chaotic and dysfunctional non-system” (p. 126). Further, he sees a reductive focus on patients as mere biological entities, ignoring their personal, familial, and cultural natures. As a result, “Caregiving in medicine has gone from bad to worse.”

Joan suffers from an atypical kind of Alzheimer’s that increased over “that dismal ten years” (p. 156) with Arthur providing care to her, at cost to himself. There is no home health aide, no team approach with doctors, indeed no wider interest in her care other than the state of her diseased brain. Kleinman vividly describes the toll on her and on him.

Kleinman is aware of the privilege he has as a Harvard doctor, well known for his psychiatric work, his teaching and writing, and his wealth—in contrast to other patients and families. Some patients go bankrupt from medical bills.

Visits to nursing homes reveal a wide range of social conditions, contexts, and levels of care; the best have a sense of “moral care” (p. 200). Joan’s final days are hard. Supportive family members agree to her living will and healthcare proxy for morphine pain control only. She dies, apparently “at peace” (p. 232).

In the last pages Kleinman introduces the notion of “soul” as “essential human interactions” (p. 238). He discusses some of the limits of medicine (see paradoxes below) but also praises local efforts to improve humane care, such as team approaches, uses of narrative medicine, and medical/health humanities programs.  

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