Showing 331 - 340 of 912 annotations tagged with the keyword "Patient Experience"

Annotated by:
Woodcock, John

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Mr. Watanabe (Takashi Shimura), a Tokyo City Hall bureaucrat near retirement, discovers he is dying of stomach cancer. Reflecting on his life, he finds that it has been empty, that he has not really lived. He devotes the time he has left to modestly exploring the possibilities of living. In a final effort to give his life meaning, he forces a reluctant bureaucracy to turn a badly drained neighborhood area into a park for children.

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Annotated by:
Schilling, Carol

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

On February 16, 2003, readers of The New York Times Magazine came upon Harriet McBryde Johnson's cover story, "Unspeakable Conversations," and a remarkable image of her gazing directly at those readers from her power wheelchair.  Her story memorably recounts her uncompromising, yet civil disagreements with Utilitarian philosopher Peter Singer about nothing less than the value of her life.  That narrative essay is one of eleven stories published in Too Late to Die Young.

They make the case that philosophers and others have incorrectly imagined Johnson's life, and the lives of others with chronic and disabling conditions, as burdensome and not worth living.  Born with a degenerative neuromuscular disease, Johnson grew up in a family that appreciated her; she practiced law in her native Charleston, South Carolina, and became nationally known for her disability activism.  Still, she encountered a world filled with people who feared her condition.  Fear, she found, led them to assume that disability inevitably brings suffering and to use that assumption to justify acts that would prevent her birth.

Her stories, conversationally and often humorously, ask readers to question why they burden some people with calls to justify their lives or to assure the world that they experience pleasure.  Each story recounts an episode that reveals the pleasures Johnson experienced as an active agent in the world.  She ran for a county office, represented her state at a Democratic National Convention, stood her ground for free speech and against Secret Service tactics when President Reagan spoke at her law school, protested Labor Day Week-end telethons, traveled to Cuba to cover a disability conference for a magazine, advocated for clients in employment discrimination cases, and made many, many friends.

Feeling exhilarated rather than confined by her wheelchair, she bears witness, perhaps unexpectedly, to another pleasure:  "the simple delight of movement."  She writes of maneuvering around Charleston, "I zoom through chaotic swarms of tourists, zip around the raggedy sidewalks . . . loop around every inconveniently placed garbage can, with maximum speed and also with style and grace" (252).  But her stories also describe her wheelchair stumbling over incompatible surfaces, one of which sends her to an emergency room far from home.  This episode also brings moments of grace, this time with the ER staff.  After learning who she is, they Google her on-line profiles and writings.  Delighting in their patient with unpredictable needs, they place print-outs of her electronic portfolio in her chart.

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A Face of Stone

Williams, William Carlos

Last Updated: Jul-08-2009
Annotated by:
Woodcock, John

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The overworked doctor-narrator finds himself extremely irritated by the requests of a poor immigrant couple in their twenties to examine their infant. He spouts an alarming number of cultural and economic prejudices and tries to avoid seeing them. They persist, however, and the doctor examines the child, whom he finds healthy. The husband then asks if the doctor can examine his wife. The doctor flashes his anger again but agrees.

He finds her legs extremely bowed, probably from severe childhood rickets, and asks the husband about her history. It turns out that she had grown up in Poland during World War I and had lost all her family. As he hears of the woman's suffering, the doctor becomes empathetic, suddenly understanding the couples' fearful tenacity which had so annoyed him before. The woman responds in kind, and the doctor-patient relationship changes significantly for the better.

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This collection of stories offers a sidelong view of medicine from the perspective of a thoughtful, experienced doctor of internal medicine at a teaching institution (UCSF) in an urban setting that brings a wide variety of types of patients to his door.  In a context of evident respect and admiration for even the quirkiest of them, Watts admits to the kinds of personal responses most have been trained to hide-laughter, anger, bewilderment, frustration, empathetic sorrow.  The cases he recounts include several whose inexplicabilities ultimately require action based as much on intuition as on science.  He includes several stories of illness among his own family and friends, and makes it clear in others how his professional decisions affect his home life and his own state of mind.  

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Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Triggered in part by a trip to the Galápagos Islands, the author interweaves two parallel narratives: Darwin's "journey toward evolution" along with the related work of Alfred Russel Wallace; and the author's own journey through life, partially disabled and dependent on the specially fitted shoes that help him to walk.  Together these two narratives develop "all I have come to understand about chance and change, fear and transformation, variation and cultural context, ideas about the body that question the definition and existence of difference in all of our lives" (xvii).

Born with an unnamed congenital condition in which his fibulae are absent along with other lower limb "abnormalities," Fries underwent five major reconstructive surgeries as a child, but after those, what helped him most were special shoes that were fitted to his special body, assisting him to walk.  As an adult, however, he begins to experience back pain and knee problems.  The memoir relates, both in flashback, and in the present day, Fries's quest for a proper pair of shoes that will help him avoid yet another surgery -- the shoes he has been wearing are 20 years old and no longer do the job.  We meet Dr. Mendotti, who treated him like a peculiar specimen and offered a pharmacologic way out of his pain; shoemaker Eneslow, in a dingy Union Square office, whose shoes not only fit Fries well, but were festive in appearance -- "I felt both normal and special" (17); other practitioners of orthotics who try but fail to construct shoes that relieve Fries's pain, and finally, the gifted, patient orthoticist, Tom Coburn, who persists until he is able to provide shoes that work.  The shoes have been adapted for Fries's body, just as man has constructed adaptations that allow him to live in a variety of climates and circumstances.  Conversely, Fries, convinced he "can adapt to the circumstances in which my body places me (169)," draws from Darwin, whom he quotes: "individual differences are highly important for us, as they afford materials for natural selection to accumulate" (169).
 
Darwinian connections are invoked throughout the narrative.  The peculiar configuration of Fries's feet and shoes help him to ascend a series of mountain ladders while his partner, Ian -- who usually has to assist Fries with such physical maneuvers -- suddenly becomes fearful of the height and exposure;  back problems might have developed even without his congenital abnormalities because evolution of the capacity to walk upright included the tendency toward back pain; the role of chance in natural selection and the role of chance in the physical fact of congenital conditions; the positive role that his partner Ian's attention deficit disorder (ADD) could have played in the days of hunter-gatherers and the cultural context in which ADD is now considered to be "abnormal."
 
Fries discusses his fears -- both rational and irrational -- as well as his awareness of stigma, difference, and sameness.  The context of these discussions is usually a reminiscence about vacations in far-flung countries (Thailand, the Galápagos, Bali, Alaska, the Canadian Rockies) and physically challenging domestic locales (a Colorado River raft trip, the Beehive Mountain in Acadia National Park).  He  occasionally brings into the discussion his homosexuality, especially as his physical deformity affected sexual encounters.  The relationship between Fries and Ian is woven throughout the memoir as one of understanding, mutual need and benefit.  As the memoir ends, Fries worries about the likelihood he will need a wheelchair, but is at the same time gathering confidence in his ability to ride the Easy Flyer bicycle that Ian has discovered at the local bike shop.

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Summary:

John Romulus (also known as Richard) Brinkley was a physician (in the diploma-mill sense of the word) who, in 1917, pioneered, in the U.S. at least, the notion of goat testicle transplant. "Transplant" must be understood in the loosest sense of the word since Brinkley simply removed the testicles from young goats and sewed them into the abdominal wall and scrotal tissues - without any attempt to connect blood or nervous tissues of either goat testicles or human  - of men for the alleged purpose of relieving impotence. From 1917 until his downfall at the hands of Morris Fishbein, a medical crusader esconced in the AMA, which organization Dr. Fishbein helped establish as the premier advocate of organized medicine in the U.S., Dr. Brinkley was perhaps the most recognizable physician in the U.S.

He ran for the office of Governor of Kansas in 1930 (losing by technicalities that today would have overturned the results), and established the most powerful radio station in the land, XERA, that promulgated his glandular chicanery all across the continental U.S. As a proponent of such skullduggery, Brinkley was continually in the sights of Dr. Fishbein, whose main reputation nationally was as an exposer of medical fakery. Eventually Fishbein lured Brinkley into a libel trial that resulted, in 1939, in the catastrophic downfall of an immensely talented and wealthy man who spiraled into bankruptcy and death in 3 short years.

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In the Introduction the editors describe the "day of reckoning" they each experienced at one point--the sudden realization that they were "fat." Prior to this insight, they had identified fatness with negative characteristics, like being funny or undesirable; the breakthrough came when they were able to experience fatness as simply factual and not value-laden. This freed them to enjoy their lives without looking over their shoulders, so to speak, to see how other people reacted to them. Their liberating insight led to this anthology, which consists of "works of notable literary merit...that illustrate the range of ’fat’ experience." (p. xiii)

A number of the stories and poems in Who Are You Looking At? have individual entries elsewhere in this database. These include: Andre Dubus, The Fat Girl; Stephen Dunn, Power; Jack Coulehan, The Six Hundred Pound Man; J. L. Haddaway, When Fat Girls Dream; Patricia Goedicke, Weight Bearing; Rawdon Toimlinson, Fat People at the Amusement Park; Monica Wood, Disappearing; and Raymond Carver, Fat (annotated by Carol Donley and also by Felice Aull and Irene Chen).

One of the outstanding pieces in the anthology is a long story by Junot Diaz entitled "The Brief Wondrous Life of Oscar Wao" (42 pages). Oscar is a Dominican boy who is both fat and a nerd. He is obsessed with girls, but none will have anything to do with him, until he meets Ana who becomes his (platonic) "best friend" until her boyfriend Manny returns from the Army.

As narrated by Oscar’s sister’s boyfriend, things go from bad to worse until Oscar spends a summer in Santo Domingo and meets Yvon, an older woman whose former boyfriend, the Captain, is a cop. When Oscar pursues Yvon, he first gets beat up and later the Captain kills him, but before the end he actually makes love to Yvon. In his last letter to his sister, Oscar writes, "So this is what everybody’s always talking about! Diablo! If only I’d known. The beauty! The beauty!"

Editor's note (4/14/09): The Brief Wondrous Life of Oscar Wao was published as a full-length book in 2007 and won the Pulitzer Prize.

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The Good Priest's Son

Price, Reynolds

Last Updated: Mar-23-2009
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Mabry Kincaid, a New York art conservator is flying home on September 11, 2001, when news comes to him on the plane of the attacks on the World Trade Center.  Unable to return to his apartment in the city, he decides to visit his aging father, an Episcopal priest, in his boyhood home in North Carolina. There he meets Audrey, an African-American seminary student in her forties, who has moved in to care for his disabled father.  In the ensuing weeks Mabry is led to reflect deeply not only on the fate of the country and of his career, but on how his father's apparently final illness compels him to come to new terms with their constrained relationship. The death of the brother Mabry always believed to be the favorite has left a painful chasm between father and son, made more so by his father's own admission of favoritism.

At the same time Mabry is coming to terms with his own diagnosis of multiple sclerosis and with the grief he continues to process since his wife's death from cancer.  Audrey and her son bring a new dimension to the life of the household and a widened sense of family to the two men as they struggle to lay the past to rest and to accept the radical uncertainties of the personal and national future. One interesting subplot involves Mabry's discovery of what is reputed to be a minor, uncatalogued Van Gogh painting, covered by the work of another artist, that he has brought home for his employer, now dead, and his musings about what to do with this undocumented treasure.  The question remains open for symbolic reflection as he leaves it behind in North Carolina and returns to New York for a very different kind of life than the one he left. 

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Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

In this candid chronicle of what many would call a prolonged depression occasioned in part by her husband's illness and death, Norris, a popular memoirist and essayist, seeks carefully to distinguish the psychological or psycho-medical category of "depression" from the spiritual state of "acedia" or, more bluntly, "sloth," in its oldest and most precise sense.  In doing so she raises important questions about widespread and often imprecise use of categories derived from clinical psychology, an imprecision that may muddy the distinction between spiritual and psychopathological experience.

"Acedia" she defines as a failure of will, signifying a need for spiritual guidance and prayer, whereas "depression" requires medical treatment.  Going beyond the confessional, Norris suggests that acedia may be an endemic condition among middle-class Americans, over-busy but spiritually slothful.  The book is loosely organized, often characteristically lyrical, and more invitational than diagnostic.  Her purpose, finally, seems to be to inspire readers to embrace simple life-giving spiritual disciplines like reading the Psalms as a stay against excessive self-preoccupation and actual depression as well as spiritual depletion.  

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Annotated by:
Bertman, Sandra

Primary Category: Performing Arts / Film, TV, Video

Genre: Video

Summary:

Filmed at Shands (teaching) Hospital in Florida, this documentary validates the importance of the arts and expressive therapies in all aspects of health care, including medical education. Pediatric oncologist John Graham-Pole and poetry therapist John Fox -often as a team- work with patients of all ages in groups and at the bedside.   Other physicians including a neuroscientist provide rational explanations of the release of endorphins and brain changes resulting from creative activities.  Though the healing process initiated by the reflective act of writing poetry is ostensibly the focus of the film, the documentary is permeated with the transforming effects of dance and art therapies in their ability to lessen physical and emotional pain; the importance of healing environments, not just paintings in lobbies, but in patient created ceiling tiles and wall installations; and especially the warmth, intimacy and humanity generated by exemplary physician communication skills.

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