Summary:

The narrator of this novel, fifteen-year-old Christopher Boone, is autistic (or, more accurately, probably, has Asperger's Syndrome). He lives with his father and believes his mother died two years before. Christopher is extremely good at mathematics, seems to have a photographic memory, but does not like novels (other than detective stories, which are about observation and logic), because he cannot empathize with human emotions or make sense of the indirect or figurative. For Christopher, metaphors, like fictions, are lies. He is very fond of dogs, and hates to be touched by people.

When a neighbour's dog is killed, he decides to investigate and, with the encouragement of his teacher, to write a book about his investigation. He quickly makes some very disturbing discoveries. He learns that his mother is not dead after all, but living in London with the husband of the dead dog's owner. The fact that his father has lied to him devastates Christopher. He runs away to London to find his mother, and his courage and tenacity allow him to solve not only the mystery of the dog's death but that of his family's past and future.

View full annotation

Summary:

This guide identifies short film clips designed to support “Cinemeducation,” word and method both coined by the editor Matthew Alexander. The editorial team consists of three family therapists--two psychologists and a social worker—with input from 26 other psychologists, behavioral scientists, and family physicians—all American, with the exception of one Brazilian. Most contributors train residents in family medicine. Both more and less than a scholarly treatise, this book is predominantly an annotated index.

Thirty short chapters are devoted to various subject themes: chronic illness, sexual behavior, aging, substance abuse, research, and medical error. In a paragraph or two, the clinical problem is outlined, then subheadings introduce specific, related keywords exemplified by the scenes selected. The plot and main actors of every film are summarized briefly at its first mention; a single movie can be cited in several different chapters. Each clip is similarly described and located precisely within the film (minutes and seconds).

In this manner, 125 films are parsed for 400 scenes, ranging in length from 1 to 6 minutes.  Most are Hollywood films, released since 1980. Questions for discussion accompany each film clip. The consistency and concise descriptions are admirable, but, sadly, the year of release is not supplied. 

A few chapters break from this format. One discusses aspects of technology. Another attempts evaluation of this teaching method through a ten-year retrospective survey of physicians who had been exposed to films in residency. The response rate was 60% but a fifth were rejected because the respondents could not recall the use of films. The remaining 48% who could remember the use of film clips found the method memorable, fun, and effective; however, they thought it would benefit from more context and amplification.

Appendices point to similar resources and more films under other keywords without details. This database is cited by URL without any description.

View full annotation

Summary:

In 2008, editor and physician Paul Gross launched a new online publication, "Pulse--voices from the heart of medicine" (published by the Department of Family and Social Medicine, Albert Einstein College of Medicine and Montefiore Medical Center). This anthology contains every poem and first-person narrative published during Pulse's first year, arranged in five sections corresponding to publication date and not to theme: Spring, Summer, Autumn, Winter, and Spring.  Paul Gross, in his introduction, states "After more than a decade of practice as a family doctor, I came to appreciate that the science I'd learned in medical school, though powerful and useful, was also incomplete . . . . it contained much truth about illness and healing, but not the whole truth" (xvii).  Like many other caregivers, Gross discovered "that writing and sharing my healthcare stories with others was therapeutic" (xviii).  He looked to "Sun Magazine" as an example of how first person narratives, both prose and poems, could turn "hurts and triumphs into something potentially beautiful, funny or moving" (xviii). 

The poems and prose that arrive every Friday online to Pulse's thousands of subscribers (and the selections in this anthology) are carefully screened by the editors according to these guidelines: the stories have to be first-person, and they have to be true, recounting the writer's own experience.  Submissions are accepted from any person involved in healthcare.  The language used must be "clear, simple language.  No medical jargon. No arcane literary devices" (xx).  Gross and his editors decided that Pulse would not be a medical journal nor a literary magazine--its purpose fell outside the perimeters of both genres--and so Pulse, and this anthology, offers work that is, in a refreshing and honest way, different from the slick or more polished poetry and prose that might be found elsewhere.

In reading this anthology from cover to cover, and so from season to season, I found that the poems and prose seemed to fall into several categories: Personal musings, in which authors relate healthcare experiences that engender intimate and revealing narratives about their own lives--among the best of these are "Well Baby Check," p.3; "Finding Innisfree," p. 31; "First Patient," p. 39; "Losing Tyrek," p. 45; "Carmen's Story," p. 62; and "Chemo? No Thanks," p. 106.  Other pieces are commentaries on the other side of healthcare, the one that cries out for reform and affects both patients and caregivers.  Among the best of these are "Redesigning the Practice of Medicine," p. 9; "A Brush with the Beast," p. 22; "Rx," p. 60; "Halloween Horrors," p. 69; and "Brain Cutting," p. 136.

Other pieces are humorous ("Aunt Helen Sees a Ghost," p. 6) or political ("My War Story," p. 11), and many poems and prose pieces speak of patient encounters or about being a patient, some more anecdotal, relating a specific incident that affected the author ("Once," p. 41) and others multi-layered, some relating medical student or intern experiences ("Jeannie," p. 48; "A View from Nepal," p. 87; "Ripped from the Headlights," p. 90; "Snowscape," p. 97; "First Night Call," p. 100; and "Wounded Messenger," p. 114.)  The "category" I found most interesting and most unique are the selections I will call "confessions."  These writings--demonstrating openess and bravery on the part of the authors--tell of regrets, mistakes, sorrows, wrong calls and other mishaps that occur, daily, in the practice of healthcare.  In these, the most human face of caregiving is revealed.  Although most of the pieces in this anthology contain elements of "confession," the most specifically revealing include "Mothers and Meaning," p. 14; "Physician's Exasperation," p. 44; "Confidential," p. 53; "My Patient, My Friend," p. 73; and "Apologies," p. 104.

Editor's note: Coincidentally, a recent relevant paper on confessional writing by physicians expounds further on this topic:"Bless Me Reader for I Have Sinned: physicians and confessional writing" by Delese Wear and Therese Jones (Perspectives in Biology and Medicine, Vo. 53, No.2, Spring 2010, pp. 215-30).

 

View full annotation

Summary:

A number of expressionless faces blindfolded, bandaged, many eyeless, some with hats of the 1930s, glasses, masks, bullet-ridden helmets, comprise three fourths of the canvas.  Anything but a group portrait, these totally disconnected faces staring straight ahead are all on different planes. None are connecting with another. Remnants of crematorium smoke stacks and a burned city are the only visible detail in the upper fourth of the canvas, from which a series of tired male refugees, painted in a much smaller scale, appear to be walking down into the portrait.

View full annotation

Summary:

The author, a young physician, guides the reader in temporal sequence through her years as a medical student, medical resident at several levels, and into the final days of her formal training. The format of the work is anecdotal, that is, a series of memorable patient encounters that seem to shape the writer's developing attitude toward her chosen profession. The precise time frame of the experiences is not clear, but this is an acknowledged story of growing into the practice of medicine as a trainee at Bellevue Hospital.

In describing her interactions with her patients, Dr. Ofri reveals her own doubts about her ability to accomplish some of the things expected of her as "healer." As she grows more confident with experience, she begins to challenge some of the rituals in which medical education seems mired. Each of the chapters is a self-contained story focused on a particular patient, some of which have been published previously as free standing essays. The composite is the physician-writer's personal narrative of her own growth and change.

View full annotation

Summary:

An animated documentary is the unlikely category assigned by producer/director/writer Ari Folman to this distinguished film.  In broad strokes the film is a memory-recovery narrative, the director’s pursuit to fill in the "black holes" in his recollection of the days, during the 1982 Lebanon War, surrounding the massacres at the Palestinian Refugee Camps of Sabra and Shatila by Christian supporters of the assassinated Phalangist leader Bashir Gemayal.  While the film finds its climax in the Palestinian genocide, along the way it examines the experience of ordinary Israeli soldiers in richly provocative storytelling –as these accounts are textured by a twenty-year time lapse, which offers perspective, insight, telling gaps, and small revelations, as, for example, when we learn that one character abandoned his ambitions to be a scientist after the war, left Israel to grow wealthy selling falafel in The Netherlands.

Folman recounts the soldiers’ narratives of disorientation, terror and loss by representing not only their experiences, but their dreams, hallucinations, distorted memories –all of which are rendered with exquisite power, mostly in vividly nightmarish cut-out animation. Added to these narratives are interviews with a psychologist, a trauma expert, a reporter who was on the scene at the refugee camps and others –adding texture and commentary to an already multi-layered story.

This films provides a fresh engagement with issues of memory and trauma, and explores the dynamics between the trauma of a nation –not only a war but the deep unexamined scar of “indirect responsibility” for a genocide— and the trauma of an individual soldier.  Representing the soldier’s war as a lonely, companionless and even passive experience, the film works to undermine a host of cinematic conventions. The viewer becomes alert to the paradox that the animation has the estranging effect of making what it recounts more “real” through its access to characters’ interior states.

View full annotation

Summary:

I believe the best way to describe this partly autobiographical story is as an illness travelogue. Alexie prepares his reader for a strange journey by making the first stop his discovery of a dead cockroach in his suitcase. This allusion to The Metamorphosis works wonderfully well for the Kafkaesque remainder of the journey.  His bodily journey moves from loss of hearing to possible meningioma to his doctor's proclamation that his "brain is beautiful." His existential/psychological/cultural journey, triggered by his bodily suffering, moves in multiple directions: to time spent with his dying father, his own experience with hydrocephalus, his grandfather's death in WWII, and his loving relationships with his children, wife and brother-in-law.

View full annotation

Summary:

This is a novel that begins with a fatal school bus accident in Sam Dent, a small town in upstate New York. The circumstances leading up to the accident appear in the first chapter, whose narrator is the bus driver Dolores Driscoll. The remaining chapters have three different narrators: Billy Ansel, who lost a son and daughter and now drinks himself into a less painful state; Mitchell Stephens, a lawyer from New York City who appears days after the accident, fueled by his belief that there is no such thing as an accident, himself the grieving father of a drug-addicted daughter; Nichole Burnell, a teenage survivor of the crash, now a parapalegic. Each presents a different view because of the unique history each brought to the tragedy.

View full annotation

Summary:

Prozac Nation is Wurtzel's memoir of her depression, which she traces from the age of 11 to her senior year in college in chapters marking different phases or manifestations of her illness. The book situates her illness squarely within her family dynamics where she found herself the "battlefield on which [her] parents' differences were fought," and describes in excruciating detail her inner life that at any given time was marked with a "free-flowing messy id" to nihilism, numbness, rage, and fear, ultimately leading to a suicide attempt. The last few chapters chronicle her slow "recovery," due to her conflicted relationship with psychopharmacology and an extraordinary psychiatrist.

View full annotation

Summary:

Because this lucid, rich, and incisive book has not, as yet, been published in the United States, it has not acquired the readership it deserves. For those teaching Medical Humanities or those interested in broader or more global stories and perspectives about physician training, practice, and experiences, Helman’s most recent publication should be considered.

Part One (“Setting Out”) begins in South Africa where Helman’s family, comprised of a dozen doctors, has lived for generations and where his own medical studies occurred. As a child, he accompanied his father on rounds while other children spent holidays at the beach. Before long he discovered how hospitals, during the madness of Apartheid, were to “some extent a distorted mirror-image of the world outside” (3). Appalled by the differences in care and treatment, the keenly aware young man kept notes. His vivid observations of the harsh context of social injustices provide an unequivocal, eloquent, and disturbing critique of medicine then and there. His acute observations of physician behaviors and indigent populations in the city and in the bush contribute, as readers discover in later chapters, to the author’s expanded and compelling interests in cultural anthropology.

Part Two (“The Family Doctor”) leads to London. “After all the heat and light and space of Africa, London—with its low leaden sky and constant drizzle—was like living inside a Tupperware box, one stored deep inside a refrigerator” (47). In the 60s Helman’s migration required an adjustment to a world of technology and order, where as a family practitioner, he had become, in fact, a suburban shaman. In any society, patients wanted “relief from discomfort, relief from anxiety, a relationship of compassion and care, some explanation of what has gone wrong, and why, and a sense of order or meaning imposed on the apparent chaos of their personal suffering to help them make sense of it and to cope with it” (xvi).

Gradually Helman saw connections between the role of family physician and traditional healer: both involved an understanding of “not only a body’s internal equilibrium but also the equilibrium of the patient’s relationships with the world he or she lives in and how treatment should aim not only to treat the diseased organ but also to restore the patient’s life that equilibrium of relationships” (xvii). His encounters with patients and the stories they reveal suggest how important these often overlooked connections are and why they ought to be included in medical training and practice.

By the time readers reach Part Three ("States of the Art”), the author has moved into broader realms of thinking, in which medicine and illnesses are examined anthropologically. After 27 years of clinical practice Helman’s white coat and stethoscope are placed on a hook. Now, as a credentialed anthropologist at University College London, his larger lens allows for sustained scrutiny of the complexities, ambiguities, and nuances in such chapters as “Grand Rounds,” “Hospitals,” “Placebos,” “Third Worlds.” Helman’s range of experiences, multi-disciplinary training, intellectual conclusions, and abundant common sense argues for techno-doctors to learn from holistic practitioners. Whether devastating or humorous, the critiques reflect not just care provision but shared human capacities: the insights are thoughtful and fresh and very worthwhile.

View full annotation