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Born to Be

Cypriano, Tania

Last Updated: Feb-26-2021
Annotated by:
Glass, Guy

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Born to Be is a documentary about the trailblazing work being done at the Mount Sinai Center for Transgender Medicine and Surgery.   

The film’s central figure is Jess Ting, a plastic surgeon who studied music at Juilliard before making a career switch to medicine.   Scenes of him with patients are interspersed with domestic clips where he is at home with his children and playing the double bass.  Just a few years ago Ting had never even performed a single gender-affirming surgery.  He is the first to admit that he did not expect his career to take this turn: “Essentially, they just asked everyone else, and everyone said no except for me.  Everyone thought I was nuts.”  Be that as it may, Ting appears to have found his calling.  In a short time, he has performed well over a thousand gender-affirming surgeries, pioneered new procedures, and helped to start a fellowship training program.  

The stories of several of the Center’s patients are interwoven with that of Dr. Ting.  One client, Cashmere, is a retired sex worker.  Years of botched silicone injections have left her face chronically swollen.   Now in her 50’s, she hopes to have the effects reversed, and to finally undergo the vaginoplasty she has been dreaming of her entire life.  Another patient, Devin, 22, goes through a transition during the course of the film, renaming herself Garnet.  Not withstanding strong family support, years of bullying in school have taken their toll as she struggles with depression. 

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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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Summary:

Doctor’s Choice is a collection of 16 stories by authors from and well known in the early-to-mid 20th century. I offer four summaries of the stories that I am considering using in teaching.

“Rab and His Friends” by John Brown, MD, was originally published in 1859 and is sometimes referred to as young adult literature. It was one of Brown’s most successful works. The story is told in the voice of a medical student, “John”, and begins with his reminiscence of six years earlier when he first met the old “huge mastiff” Rab, and his “master”, a carrier named James Noble. John, who had befriended Rab during medical school, next sees him ‘one fine October day’ as he was leaving the hospital. Rab was with James who was bringing his wife, Ailie, to see a doctor because “she’s got a trouble in her breest…” (p.37). Examination showed no doubt that the tumor needed to be removed. Having survived the breast amputation (without anesthesia and observed by the narrator and his fellow students), four days later Ailie’s delirium set in. With James by her side, and with tender caring, Ailie died a few days later. Soon after James took to bed “and soon died…The grave was not difficult to reopen. A fresh fall of snow had again made things white and smooth; Rab once more looked on, and slunk home to the stable” (p.46). The next week John sought out the new carrier who took over James’s business to ask about Rab. The new carrier tried to brush him off—but admitted he killed the dog, explaining that the dog was inconsolable and that he had to “brain him wi’ a rack-pin….I could do naething else”(p.46). John thought it a fitting end… “His teeth and his friends gone, why should he keep the peace and be civil?”

“Miracle of the Fifteen Murderers” by Ben Hecht, was originally published in Collier’s Magazine in 1943. The narrator of this story passes along a tale he heard from an elderly friend, a physician who was one of 15 eminent physicians that formed a secret group meeting quarterly to discuss the ‘medical murders’ they had committed. The group had been meeting for the past 20 years, but had disbanded due to the outbreak of WWII—“The world, engaged in re-examining its manners and soul, had closed the door on minor adventure” (p.139). The last meeting of the group is the subject of the tale and it describes how the newest member, a young surgeon, tricked the group into providing the diagnosis for a patient this doctor, Samuel Warner, was struggling to care for. Warner explained that his patient—who he had befriended--, a young Negro boy of “seventeen, was an amazingly talented [poet whose work] “was a cry against injustice. Every kind of injustice. Bitter and burning,” (p.149). After working hard for 2 weeks to save his life, and realizing that his diagnosis of ulcerative colitis was wrong, Warner’s scheme (a feigned medical murder) got the eminent physicians to the diagnosis: a fishbone had caused the perforation that was threatening the poet’s life. Grabbing his hat and coat—and after thanking the doctors for the diagnosis- Warner is off to save his patient’s life. A half-hour later, rising to the call as well, the other 14 doctors joined Warner in the operating room to view the life-saving procedure, allowing one of the eminent physicians to remark with a soft cackle, that “the removal of this small object….will enable the patient to continue writing poetry denouncing the greeds and horrors of our world” (p. 154). 

There was no original publication date for “The White Cottage” by L.A.G. Strong, but it has been anthologized since at least 1940. The narrator tells of a visit by a locum town-based doctor to an island nearby to help a woman give birth at her home. The perilous journey from the town to the island with the expectant father and a neighbor as navigators and rowers ends with all thoroughly drenched from a storm after nearly capsizing. Realizing that the doctor has no dry clothes to change into, the couple offers him the husband’s flannel nightgown and a blanket. The doctor, after checking the wife and estimating a number of hours of labor ahead, goes to the living room by the fire. Fearing he’s still chilled, the couple decides to make room in their bed for him. After hesitating for a moment, he climbs in next to the husband. After some small talk and an ‘order’ for the soon-to-be mother to lay on her side and have her husband rub her back, the doctor begins to assess the situation he finds himself in: “Right living was not obedience to rule: it was a balance, renewed each instant, like a tight-rope walker’s, a tension between opposites. Here, for a moment, in this bed, in this cottage, in this tiny focus of life, beneath storm and towering sky, was wisdom. Men did not possess wisdom. It possessed them. Like a light, it flickered here and there over the vast dark mass of humanity, illuminating briefly every now and then a single understanding. Here, for the moment, it possessed him; and by its light he gave thanks, and loved all men” (p. 249). After a successful delivery (and some celebratory drink and breakfast), the doctor was off to his town with a promise to return for a checkup. His new friend demurred. “No trouble man. It’s a pleasure—besides being my plain duty. Mind you, she’ll be right as rain. But I’ll come” (p.252), responded the doctor. After a silent handshake, and suddenly finding “eyes full of tears … he clambered into the boat” (p. 252).

“Doc Mellhorn and the Pearly Gates” by Stephen Vincent Benet was originally published in 1929. The story begins with an in-depth description of a humble, impish (having mastered many diversionary tricks), and independent small town doctor and the place he practices, but quickly moves to much larger realms through Benet’s use of magical realism. Doc Mellhorn has died but has not fully landed in his final destination, heaven, and decides to spend a bit of time in hell first because of the perceived lack of opportunity to practice medicine in heaven (and an off-putting encounter with an overly officious clerk at the pearly gates). When he gets to hell, he gets to work on setting up a clinic—“mostly sprains, fractures, bruises and dislocations, of course, with occasional burns and scalds… [reminding him] a good deal of his practice in Steeltown, especially when it came to foreign bodies in the eye” (p.23). After a number of months, and a confrontation with another officious bureaucrat, Doc got back on the road to his original destination, giving him some time to think about whether he was deserving of that final abode. “I’m a doctor. I can’t work miracles,” he thought. “Then the black fit came over him and he remembered all the times he’d been wrong and the people he couldn’t do anything for” (p.28).  Landing for a second time at the pearly gates, he finds family waiting for him with assurances that there’s more than just eternal peace in heaven. “They wouldn’t all arrive in first-class shape," (p.31) explains his Uncle Frank, assuring him that there will be lots of work for him to do. Uncle Frank also lets him know that a delegation is coming to meet him since Doc had “broken pretty near every regulation except fire laws, and refused the Gate first crack” (p. 32). Then, out of a phalanx of famous doctors (from a list that Doc began to create during his first, shortened visit), appeared—with “winged staff entwined with two fangless serpents”-- his top choice--- Aesculapius. “The bearded figure stopped in front of Doc Mellhorn. Welcome brother, said Aesculapius. It’s an honor to meet you, Doctor, said Doc Mellhorn. He shook the outstretched hand. Then he took a silver half dollar from the mouth of the left-hand snake” (p.32). ….I laughed out loud—and couldn’t imagine a better ending.




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Summary:

The Doctors Blackwell begins with an account of an auspicious new beginning—the opening of The New York Infirmary for Indigent Women and Children, the first women’s hospital staffed by female physicians. Founded in 1857 in New York City by Drs. Elizabeth and Emily Blackwell with the express purpose of providing clinical experience to female physicians, the hospital was a landmark achievement in the long struggle for parity in medical training. The Doctors Blackwell goes on to trace the history of the institution and of its two founders, themselves trailblazing members of the medical profession as the first and third women to earn medical degrees in the United States.

Two of nine children born to abolitionist, Protestant dissenters in Bristol England, Elizabeth and Emily Blackwell were the recipients of a strict moral upbringing. While successful in instilling the values of education and hard work, their childhood also left them socially awkward and with the sense that they were both morally and intellectually superior to those outside of their family. When the Blackwells emigrated to New York City in 1832 and then on to Cincinnati in 1838, their social circles were confined to religious and abolitionist advocacy. Yet soon after the family arrived in Cincinnati their lives were upended by the passing of their father, Samuel Blackwell. With their mother and six siblings to support, the three eldest Blackwell daughters-- Anna, Marian, and Elizabeth-- took up teaching until their younger brothers were old enough to support the family.               

Elizabeth, morally principled to a fault, studious, and determined to succeed intellectually, found teaching to be an unfulfilling means of channeling her energies. Having forsworn marriage at the age of 17, she longed for something challenging and admirable upon which to focus her formidable intelligence. When a dying friend suggested that she become a physician, because she herself would have appreciated a female doctor tending to her disease, Elizabeth’s interest was piqued. Yet her attraction to medicine was rooted not in a desire to help the ailing (indeed she viewed illness as a form of weakness), but in an ideological quest to prove that women were capable of achieving the same distinctions as any man. She saw herself as a moral crusader with the goal of uplifting all of womankind.              

Beginning in 1844, Elizabeth leveraged her teaching connections to gain the backing of several prominent male physicians. Yet the all-male world of medicine remained stubbornly closed to her, and it wasn’t until 1847 that she was admitted to the Geneva Medical College in upstate New York, an event that caused a stir in the medical community and beyond. Isolated both from her male classmates and from laypeople, who viewed her at best as an oddity and at worst as a dangerous anomaly,  Elizabeth nonetheless became a figure equally admired and reviled by the public.  Her reputation as the first “lady doctor” preceded her, even as she gained the respect and admiration of the faculty at Geneva College and distinguished herself with additional training in Europe.                    
 
Meanwhile, the trials of Emily Blackwell, whom Elizabeth encouraged to follow in her footsteps, illustrated that far from breaking down the doors that barred women from medicine, Elizabeth’s admittance may only have served to seal them more tightly. Elizabeth was viewed as a notable exception to the general rule that women were unfit to practice medicine, and her male colleagues were uneasy at the thought of being replaced. But after a prolonged struggle, Emily succeeded in obtaining her medical degree from Cleveland Medical College and joined Elizabeth to hang up her shingle in New York City.              
Increasingly frustrated by the difficulty in recruiting private patients to be seen by female physicians and by the dearth of clinical opportunities for the growing number of women in the field, Elizabeth and Emily opened their own hospital and medical school with the help of female philanthropists. Elizabeth’s philosophical zeal combined with Emily’s true love and aptitude for medicine proved to be a dynamic combination. Their contributions to the field not only changed the way that medicine is practiced, but also paved the way for generations of female physicians. Today, just over fifty percent of the nation’s medical students can trace their acceptance into the profession to the dogged determination of these two extraordinary women.   









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Elizabeth is Missing

Walsh, Aisling

Last Updated: Feb-16-2021
Annotated by:
Teagarden, J. Russell

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Maud’s dear friend Elizabeth is missing, suddenly. Maud’s dear older sister Sukey is long missing. And, Maud’s mind is missing more and more. These three facts and how they relate to one another form the matrix of this movie. Maud Horsham is an elderly widow living alone with help from a home health aide’s daily visits, and from an attentive, if occasionally resentful daughter and a loving teenage granddaughter. She is well into the inexorable decline dementia brings, but at a stage where the support in place and reminder notes she leaves around are enough to keep her functioning. 

On a routine visit to her friend Elizabeth, and while they dig in Elizabeth’s garden, Maud comes across the top of a compact that immediately takes her mind to a scene seventy years before when her sister Sukey was applying makeup with what looks to Maud as the same compact Sukey had in her hand. This flashback starts the story of Sukey’s unsolved disappearance as a young adult. A couple of days later, Maud and Elizabeth are to meet outside the Salvation Army store where they both once worked. Elizabeth never shows. 
 

Elizabeth is Maud’s only remaining friend, and Maud sets off to find her. Her search triggers many flashbacks and hallucinations from the time of Sukey’s earlier disappearance, which she then becomes determined to solve. Maud’s worsening dementia often frustrates her own efforts in these parallel missions and also causes family, friends, and officials to doubt her findings and assertions. The parallel stories each have twists, turns, and surprises all the while Maud’s dementia is progressing to where she can no longer live on her own. Nevertheless, Elizabeth is found, Sukey’s grave is found, but Maud’s mind is never to be found again. 

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Annotated by:
Miksanek, Tony

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

Pearl, a plastic surgeon and former CEO of a large medical group, writes powerfully and poignantly about the major role of physician culture - the customs and rituals, traits and beliefs of doctors. This culture is entrenched through years of medical training. He decides that physician culture "can be both a virtuous force and an equally destructive influence" (p70).

Some of that culture is readily on display: attire, tools of the trade, unique medical terminology, insensitive humor, frequent handwashing. Positive aspects of physician culture include self-confidence, integrity, compassion, and selflessness. Negative elements are ingrained to keep emotions and dread at bay: detachment, callousness, denial. This culture of medicine must navigate dual interests - healing (the mission of medicine) and profit (income, status, prestige).

Pearl suggests an evolutionary pathway for physician culture that he dubs "the five C's of Cultural Change" - confront, commit, connect, collaborate, contribute. He tackles issues of sexism, racism, and elitism in American healthcare. He explores the suffering of physicians and their need to seek forgiveness - often secretly and even in cases of perceived "failure" when everything possible was done correctly. His discussion is filled with agonizing, frustrating, and loving stories about patients, family members, and colleagues (including physician suicide).

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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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The Flight Portfolio

Orringer, Julie

Last Updated: Jan-29-2021
Annotated by:
Field, Steven

Primary Category: Literature / Fiction

Genre: Novel

Summary:

It’s 1940, and France has fallen to the Nazis, leaving the country divided between occupied France in the north, and so-called “Free France,” with its government at the spa town of Vichy, in the south.  The Vichy government is headed by Marshall Phillippe Petain, a collaborationist puppet of the Germans running a collaborationist puppet state.  But unlike the north, the south is still technically unoccupied, and people fleeing the Nazis from all over Europe make their way there in the hope of finding a way off the European continent, and so a kind of black market in emigration develops, centered in the port city of Marseille.

Among the groups working out of Marseille is the Emergency Rescue Committee, an organization set up by the journalist and editor Varian Fry and his friends, and with the support of Eleanor Roosevelt.  The ERC has sent Fry to Marseille with a list of names of people to be assisted to emigrate, and the list is a Who’s Who of the European cultural elite:  artists, writers, philosophers, and the like, many of whom are Jewish and/or have opposed the Nazis and are thus wanted by the Gestapo.  It is Fry’s job to shelter them, get them fake transit visas, and ultimately smuggle them out, usually to neutral Spain or Portugal, or even directly to the States.   The Vichy government, which has an agreement with Germany to surrender any identified fugitives, knows this is going on, and together with their German allies, is always hot on the trail of these now stateless refugees, and thus hot on Fry’s trail also. 

The Flight Portfolio is based on several of the thirteen months Fry spent in Marseille as the representative of the ERC.  Along with his staff, he “brings in” (and successfully gets out) Marc Chagall and his wife, Franz Werfel and Alma Mahler Gropius Werfel, Max Ernst, Lion Feuchtwanger, a young Hannah Arendt (“Name?”  “Johanna Arendt.  My friends know me as Hannah”), and others.  All the while, he and his staff are but one step ahead of the agents of Vichy and the Gestapo. And during this time, Chagall has been compiling the flight portfolio, a collection of artworks which testify to the humanitarian crisis in Europe, to be smuggled out as a warning to the free world. 

Complicating the issue—and a major part of the story line—is the fact that Fry, whose wife Eileen had stayed behind in New York City, has reconnected with a Harvard classmate named Elliot Grant with whom he had been romantically involved as an undergraduate.  Grant has come to Marseille to be with Gregor Katznelson, a fellow Columbia University professor who has returned to Europe to find his son Tobias who has disappeared.  Tobias is a brilliant young Berlin physicist and is wanted at all costs by the Gestapo for his scientific acumen and his value to weapons development. Gregor is desperate to secure his safe passage to New York.  Fry promises Grant that he will get Katznelson’s son to safety.  When the elder Katznelson returns to the United States, Fry and Grant resume their relationship, and Varian finds himself becoming increasingly emotionally involved with Grant and distanced from Eileen, although he still loves her.  Ultimately Tobias shows up in Marseille; but there is another fugitive, a world-renowned and respected artist, who has been waiting, is in immediate danger, and needs to get out of Europe.  And only one can leave on the waiting ship.  

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Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

This engaging and informative book describes the latest scientific understanding of the brain, primarily in humans, but also in other animals. The author, a leading brain researcher, writes clearly and often with humor. 

As Barrett explores the deep history of brains, she emphasizes that as much as some humans may prize thinking, the brain’s central task is not thinking but monitoring and guiding—day and night—the many systems of the body. Brains of all creatures manage a “budget” for various factors such as water, salt, glucose, blood gases, etc., to create an on-going fitness against any future threats.

Our brains and bodies are interlinked, interactive, and unified, not the “triune” brain Carl Sagan popularized in 1977. All animal brains have similar neurons, and all mammals share a “single manufacturing plan” for brain development after birth. Babies’ brains develop according to their genes and in response to their environment, especially to their caregivers. Human brains have flexible networks much like the global air-travel system and can vary from person to person and, individually, over time because of brain plasticity.           

Our individual brains influence—even create—our perceptions and relate to brains of other people through family, language, gesture, culture, and more. Barrett concludes, “Social reality is a superpower that emerges from an ensemble of human brains. It gives us the possibility to chart our own destiny and even influence the evolution of our species” (p. 123). 

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Holding the Man

Armfield, Neil

Last Updated: Jan-10-2021
Annotated by:
Brinker, Dustin

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

This film chronicles the short lives of two Australian gay men from their teenage years into the AIDS epidemic. Following the perspective of Timothy Conigrave (Ryan Corr), the audience witnesses the beginning of his relationship with John Caleo (Craig Scott) at an all-boys school in Melbourne during the 1970s. The two lead distinctly different lives: Timothy is a typical, sexually charged teenager involved in theatre, while John is a subdued, Catholic rugby player. With the help of three female friends, Tim finds himself kissing John at a private dinner party, beginning a stereotypically endearing teenage romance. Alas, their idyll dissolves with John’s father’s discovery of a love letter. He forbids the two from seeing each other, but being typical teenagers, the two disregard his wishes. They continue to date into college. While John is content with their relationship, Timothy expresses his desire to branch out, both in his romantic and professional lives. He applies to and is accepted by NIDA (the National Institute of Dramatic Art) and asks John for a separation while there. Tim, now unencumbered by a relationship, sleeps around in a montage of homoerotic encounters. Eventually Tim and John get back together, but their relationship, like those of most other homosexual men at that time, has become haunted by an insidious illness: HIV. On a seemingly routine check in 1985, both men are diagnosed positive. They assume that John was infected first given his worse lab values; however, Tim returns to his parents’ place for a wedding a few years later only to discover from the Red Cross that he was likely positive in 1981. Tim and John spend roughly the next decade in and out of the hospital, John’s condition being markedly worse than Tim’s. John dies in 1992. Tim is acknowledged as a “friend” in the funeral to appease John’s religious family despite their 15-year-long relationship. Having worked as a writer and activist since leaving NIDA, Tim makes use of his skill to write a memoir with John as the subject. Tim completes the memoir in 1994 Italy and dies ten days later.

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