Showing 41 - 50 of 399 annotations tagged with the keyword "Trauma"

Little Angel

Sesow, Matt

Last Updated: Jun-28-2016
Annotated by:
Lam, MD, Gretl

Primary Category: Visual Arts / Painting/Drawing

Genre: Painting

Summary:

Two harshly drawn figures make up this painting, an adult cradling a baby. Both figures stare out and confront the viewer with round bulging eyes. Their wide red mouths are drawn into grimaces, displaying long rows of teeth. Their bodies are pale, but are outlined roughly in black, and marked by gashes of blue, pink, and red. They stand, highlighted in yellow, against an angry and energetic backdrop of red and orange.  

A small black halo sticks out stiffly from the head of the baby, while two sharp black horns protrude from the crown of the adult. The adult’s disproportionately large thick hand presses the baby close to their body. Is this an adult or is it a monster or a devil? The viewer is left to decide. Whoever or whatever the figure is, it holds the baby in a way that is protective and menacing at the same time.

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A Streetcar Named Desire

Williams, Tennessee

Last Updated: May-24-2016
Annotated by:
Glass, Guy

Primary Category: Literature / Plays

Genre: Play

Summary:

The play is set in 1947 (the year it premiered) in New Orleans. Having lost their ancestral Mississippi home to creditors, Blanche Dubois arrives at the shabby French Quarter flat of her sister Stella. When we first meet Blanche she explains she is on a leave of absence from teaching high school English on account of her “nerves.” From her first meeting with Stella’s husband Stanley Kowalski, a World War II vet, we detect class conflict and sexual tension between the two of them. As Blanche’s visit becomes more and more protracted, Stanley becomes increasingly suspicious of her motives and background. Meanwhile, she begins to date Mitch, one of Stanley’s poker buddies. Gradually we learn more about Blanche’s checkered past. She was once married to a young man who committed suicide after she discovered him in a sexual encounter with another man. Stanley uncovers rumors that she was fired from her teaching job for having sex with a student. As the play progresses, fueled by her surreptitious drinking, Blanche’s mental state unravels. When Stanley warns Mitch about Blanche’s notorious reputation, Mitch rejects her.  Adding insult to injury, while Stella is having a baby, Stanley rapes his sister-in-law. Blanche’s emotional deterioration is complete. In the final scene, a doctor and nurse arrive to take Blanche to a mental hospital. She initially resists them, but when the doctor helps her up she willingly surrenders: “Whoever you are - I have always depended on the kindness of strangers"(p. 178).

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A Little Life

Yanagihara, Hanya

Last Updated: May-17-2016
Annotated by:
Teagarden, J. Russell

Primary Category: Literature / Fiction

Genre: Novel

Summary:

After first meeting as college roommates, Jude, Willem, JB, and Malcolm make their way through college and then onto New York City to pursue career interests. We follow them through the subsequent decades as Jude becomes a highly effective attorney, Willem a famous actor, JB an acclaimed artist, and Malcolm a prize-winning architect.  

What starts as a cluster of four eventually separates into an orbit of Willem, JB, and Malcolm around Jude at the center. The gravitational force pulling the three others towards Jude is the fidelity that can form among college roommates and a love that has bonded them together even more. But, there is also a strong sense among the three that Jude needs them for both physical and emotional support. At first, and for a good long time, it’s just a sense, but they later come to learn that their intuitions are right, that Jude does indeed need them and why. Over the years covered in the novel, a second orbit forms around Jude comprising a surgeon-cum-close friend, adoptive parents, a work colleague, and a neighbor. They, too, know Jude needs them, but only learn why late into their relationships. Until then, they are alternatively and often simultaneously worried, angry, flummoxed, and stymied about what’s at the root of his ambulatory limitations and severe leg pains, and why he cuts himself with terrifying frequency.  

Through a fractured narrative sprinkled with artfully-constructed subliminal hints, Yanagihara reveals Jude’s life before he arrived at college. She tells of Jude’s beginnings as a foundling taken in at a monastery. This hopeful start for Jude, however, becomes a childhood and adolescence of unrelenting, horrific, sexual assault and torture—when at the monastery, when on the road after being kidnapped by a monastery brother, when in protective custody, and even when he is able to escape. He arrives at college bearing the psychological and physical consequences of these experiences, but not openly displayed to a degree that yields more than a few hints of a traumatic past. With the support of the people surrounding him in  his adult life, he is able to become a highly accomplished attorney, and to achieve some measure of ease and happiness from time to time. The support he receives, however, is not enough to protect him from the consequences of further psychological and physical assaults, including his self-mutilation practices, and tragic losses. Ultimately, Jude engineers his own final tragedy.
 

Some of the people left behind suffer from more than Jude’s loss. His friend the surgeon wonders whether he enabled Jude’s self-cutting by always patching him up and never committing him to an inpatient psychiatric unit. Jude’s adoptive father relives the loss of his first son at a very young age to a rare, degenerative, neurological disease. Nearly all the figures in this novel experience suffering in some form or another, but this is more the story of Jude; how the people around him tried to get him past the horrors of his childhood and adolescence, but eventually and sadly to no avail. 

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The Heart

de Kerangal, Maylis

Last Updated: Apr-25-2016

Primary Category: Literature / Fiction

Genre: Novel

Summary:

The story of The Heart is a simple, linear structure.  A car accident renders a young Frenchman, Simon, brain-dead. A medical team proposes harvesting organs, and his parents, after some turmoil, agree. That’s the first half of the book, the provenance of this specific heart. The second half describes its delivery for transplantation. Administrators find recipients, one of them a woman in Paris. Simon’s heart is transported there by plane and sewn into her chest. All this in 24 hours.  
            
The narration is complex, with flashbacks, overlapping times, and literary art that is compelling. There are 28 sections to the story but without numbers or chapter headings, and these are often broken up into half a dozen shorter sections. We have an impression of stroboscopic flashes on the action, with high intensity focus. These create a mosaic that we assemble into dramatic pictures. Even major characters arrive without names, and we soon figure them out.  
 

Simon.  He’s called the donor, although he had no choice in the matter. At 19 years of age he’s trying to find a path in life.  A Maori tattoo is a symbol for that search. He has a girlfriend, Juliette. He fades away as a character (except in others’ memories) and his heart takes center stage.  

Marianne and Sean, Simon’s parents.  Her emotions, as we would expect, range widely, especially during discussion of whether Simon’s organs can be transplanted. Father Sean has a Polynesian origin and cultural heritage.


Pierre Révol, Thomas Rémige, and Cordélia Owl are respectively the ICU physician, nurse, and the transplant coordinator. These are vividly drawn, with unusual qualities. Skilled professionals, they are the team the supplies the heart.  

Marthe Carrare, Claire Méjan, and Virgilio Breva are a national administrator, the recipient, and a surgeon. Described in memorable language, they are the receiving team.              

The characters’ names give hints of de Kerangal’s range. S
ince the 1789 Revolution Marianne has been a well-known French national symbol for common people and democracy, but Virgilio Breva is from Italy and Cordélia (recalling King Lear) Owl (as in wise?) has a grandmother from Bristol, England. We learn of personal habits regarding tobacco, peyote, sex, and singing. Medicine is part of a larger world of people of many sorts.              

Even minor characters, such as Simon’s girlfriend Juliette and other medical personnel are touching and memorable.
             

These characters animate the story with their passion, mystery, even heroism. While we don’t know the final outcome of the implanted heart, the text shows the professionalism of the medical team, the French national system that evidently works, sensitive care of patients and families, and in the last pages, rituals of affirmation for medical art and for patients.
             

There is richness in de Kerangal’s style. At times it is direct, reflecting the thoughts of characters. At times it is ornate, even baroque. She uses many images and metaphors, often with large, epic qualities. A very long sentence about the over-wrought parents describes them as “alone in the world, and exhaustion breaks over them like a tidal wave” (p. 141).  The style uses many similes, often with dramatic and unexpected comparisons. There are references to geology, astronomy, even American TV hospital drama. The style is at times lyric…we might say “operatic.”  One page about Cordélia is very, very funny.
        
  
In a different tone, the details of medicine, law, and ethics are carefully presented, and visual imagery puts us in the hospital rooms, the OR, and crowded streets around a soccer game. Throughout it appears that translator Sam Taylor has done an admirable job. 
             

The text invites us to consider large visions of wholeness. All the major characters seek some comprehensive unity to their lives, and they avoid orthodoxies such as religion, patriotism, and economic gain. Sean has his Polynesian heritage and boat-building passion, which he has shared with Simon. Cordélia, at 25, is an excellent nurse, wise beyond her years in some ways, but is as dazzled by a man as any teenaged girl. Nurse Rémige has his master’s in philosophy, loves the song of rare birds, and is, himself, a serious singer.  

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Fracture

Miranda, Megan

Last Updated: Dec-08-2015
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel for Young Adults

Summary:

 After eleven minutes underwater at near-freezing temperature, Delaney Maxwell, who appeared dead upon rescue, is revived.  Unlikely as her survival seems, the return of apparently normal brain function seems even more unlikely, yet after a few days she is allowed to go home with medications and resume a near-normal life. But after-effects of her trauma linger, the most dramatic of which is that she develops a sixth sense about impending death. She hides this recurrent sensation from her parents, and from her best friend, Decker, who rescued her, but finds that she shares the experience with a hospital aide who, like her, suffered a coma after a car accident that killed his family members. Like her, he senses death in others. Gradually Delaney realizes that “normal” isn’t a place she’s likely to return to, and that Troy, the aide whose life has been a kind of “hell” since his own trauma, is even further from normal than she. Troy seems to feel that it is his mission to help hasten death for those who are dying, to prevent prolonged suffering.  The story follows her efforts to stop him, and to communicate with close friends, especially Decker, in spite of the secret she carries about her own altered awareness. When her efforts to save a friend who is dying of a seizure fail, Delaney faces another moment of crisis, compounded by Troy’s own suicidal desire to end his own suffering and hers with it. In the midst of these new traumas a clarity she has lost about what it means to choose life returns to her, and with it the possibility of a loving openness with parents and friends about the mysteries of her own brain and heart.

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Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

A pot of boiling water falls off the stove. A diaper-clad toddler screams. His mother cries hysterically. The little boy is standing barefoot in a puddle of steaming water on the kitchen floor. The father who was busy hanging a door rushes into the room and quickly assesses the situation. He places the child in the kitchen sink and runs cold water over the boy.The child's skin is scalded. The father swaddles him in a wet towel but the toddler shrieks as if he is still being burned. Suddenly both parents realize they haven't checked the diaper. It burns their hands when they take it off. The diaper is filled with hot water that has collected inside it. The parents wrap their son in gauze and handtowels. They take him to the emergency room where "the child had learned to leave himself and watch the whole rest unfold from a point overhead." (p. 116)

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The Theater of War

Doerries, Bryan

Last Updated: Oct-30-2015
Annotated by:
Glass, Guy

Primary Category: Literature / Plays

Genre: Essay

Summary:

This is a book about the author's passionate love affair with ancient Greek plays, how he goes beyond merely making them relevant to our time by finding therapeutic benefit in them, and how he finds ways to adapt them for a variety of populations and uses.  

Doerries begins by telling us about two formative relationships, representing opposite extremes, that have influenced his worldview.  In the first case, we learn how his father, a diabetic, effectively commits suicide over a period of decades by gorging himself on sweets. He rationalizes his behavior to his son by suggesting that, no matter what he does, his life is destined to end in disaster anyway like "those Greek plays." (p. 17) In contrast, we hear of the author's relationship with a young woman, doomed by cystic fibrosis, who manages to make every moment of her all-too-brief life matter. She goes on to provide an object lesson in how to die with grace and dignity.  These experiences afford Doerries an insight into mortality beyond his years. He also gains insight into his own destiny, eschewing an academic career for a path of his own making.  He follows his intuition which tells him "If I could present readings...maybe something healing could happen." (p. 66) He then begins to devise his own translations from the original Greek which he directs in dramatic readings, and he seeks out the audiences that will benefit from them.

One of the plays that captures his imagination, Sophocles's "Ajax," tells of a warrior who loses his friend to war, becomes despondent, and takes his own life. Doerries discovers that this storyline is familiar territory to sufferers of Post-Traumatic Stress Disorder.   Consequently, when he presents it at military bases it produces an abreactive effect. Indeed, the pent-up emotion he elicits has no other outlet, and he and his performers become folk heroes.  Of course, there are detractors as well.

In the remainder of the book, Doerries finds additional applications for his method, from prisoners in Guantanamo Bay to hospice providers to victims of natural disasters.


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Fire Shut Up in My Bones

Blow, Charles

Last Updated: Oct-11-2015
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Blow’s account of growing up in rural Louisiana, exposed to negligence, sexual molestation, violence, and loss focuses on a child’s strategies of survival first, and then on sexual confusion, social ambition, and discovery of the gifts that led him to his life as a writer for the New York Times.  A major theme in the memoir is his learning to claim his bisexuality after years of secrecy and shame.  That emergent fact about his identity, along with moving to New York after a life in the rural South required an unusual level of self-reflection and hard, costly choices that challenged norms at every level.  His account of learning to assume a leadership role in a college fraternity and deciding to finally leave it behind offers a particularly vivid example of what it takes to resist perpetuating rites of humiliation and conformity designed to curb individuation.     

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Annotated by:
Donley, Carol

Primary Category: Literature / Poetry

Genre: Poetry

Summary:

An African nun, in Pittsburgh, identifies with her home country of Uganda, envisioning the brutality of the civil war, torturing her father and murdering her brother. Her body is like her country--"frightened / delirious / insensate / and holy." Sleepless, she sits on the edge of her bed and prays--"her prayer is sweet, sweet medicine" both for her own distress and, somehow, for her country’s.

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Annotated by:
Miksanek, Tony

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

A bicycling, bee-keeping, British neurosurgeon approaching the end of his professional career recalls some distinctive patients, surgical triumphs as well as notable failures, difficult decisions, and mistakes. Nearly thirty years of a busy neurosurgical practice are distilled into a collection of linked stories throbbing with drama - both the flamboyant kind and the softly simmering type.

Most chapters are titled after a medical condition (exceptions are "Hubris" and "Melodrama"). Some of the headings are familiar - Trauma, Infarct, Aneurysm, Meningioma. Other chapter titles flaunt delicious medical terminology that mingles the mysterious and the poetic with nomenclature such as Angor animi, Neurotmesis, Photopsia, and Anaesthesia dolorosa.

Included are riveting accounts of both mundane and seemingly miraculous patient outcomes. One success story involves a pregnant woman losing her sight due to a brain tumor that compresses the optic nerves. Her vision is restored with an operation performed by the author. Her baby is born healthy too. But tales of failure and loss - malignant glioblastomas that are invulnerable to any treatment, operative calamities including bleeding of the brain, paralysis, and stroke - are tragically common. The author describes his humanitarian work in the Ukraine. He admits his aggravation with hospital bureaucracy and is frequently frustrated by England's National Health Service.

Sometimes the shoe falls on the other foot, and the doctor learns what it is to be a patient. He suffers a retinal detachment. He falls down some stairs and fractures his leg. His mother succumbs to metastatic breast cancer. His three month old son requires surgery for a benign brain tumor.

As his career winds down, the author grows increasingly philosophical. He acknowledges his diminishing professional detachment, his fading fear of failure, and his less-hardened self. He becomes a sort of vessel for patients to empty their misery into. He is cognizant of the painful privilege it is to be a doctor.

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