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The Mouth Agape

Pialat, Maurice

Last Updated: Nov-07-2022
Annotated by:
Teagarden, J. Russell

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

“Can you take your mother home? There’s no point our keeping her here,” the doctor says to Phillipe about his mother, Monique. Her breast cancer has spread to her spine and probably her brain. Monique had been staying with Phillipe and his wife, Nathalie, in their cramped apartment in Paris during her treatment. They took her to her home in Auvergne, and there she remained, confined to her bed, until she died. 

Monique’s husband, Roger, cared for her while also managing the family retail clothing store beneath their apartment. He spoon-fed her, cleaned her, and tried to make her comfortable with the aid of visiting nurses. Phillipe and Nathalie came from Paris to help care for Monique and provide some relief for Roger. As Monique deteriorated, she required more and more of their attention, which was made all the more difficult when she lost her ability to speak. Fatigue set in and nerves frayed. Nevertheless, when Monique died, tears were shed, hugs were shared, and memories were recounted. 

Through it all, though, not one of three family members exhibited a bit of grace. As they had before Monique became ill, they lied to each other, cheated on each other, and stole from each other while caring for her. None were above physical abuse—“you slapped me for no reason,” Nathalie reminds Phillipe, Roger paws his female customers just below where Monique lies ill in her bed. Monique, no angel herself, had behaved similarly before cancer crimped her style. After the funeral, Roger returned to his store, and Phillipe and Nathalie to Paris, where they ostensibly would pick up where they left off with their lives of banal wantonness. 
 

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Summary:

Physician-Assisted Suicide and Euthanasia, edited by Shelton Rubenfeld and Daniel Sulmasy, is an unusual collection of scholarly essays in that it combines essays about Nazi euthanasia with others that deal with contemporary PAD (Physician Aid in Dying) and questions whether there might be a relationship between the two. This perspective is understandable, given the book’s origin. The Center for Medicine after the Holocaust, an organization with the mission “to challenge doctors, nurses, and bioethicists to personally confront the medical ethics of the Holocaust and to apply that knowledge to contemporary practice and research,” invited a group of North American and Israeli palliative care specialists and medical ethicists in 2018 to visit German sites associated with Third Reich euthanasia programs.  The intensive discussions that followed resulted in this provocative collection of papers.  

Dr. Timothy Quill is among the writers supporting the moral probity and legalization of PAD, while Drs. Diane Meier and Daniel Sulmasy present strong arguments against the practice.

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Station Eleven

Mandel, Emily

Last Updated: Oct-27-2022
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

In the not-too-distant future, Arthur Leander, a famous actor, suddenly collapses and dies on a Toronto stage in the final act of King Lear.. That same night the deadly and highly contagious Georgian Flu reaches North America from Russia. Within days, civilization, as we know it, collapses: no electricity, no gasoline, no water, no travel, no Internet, no information, no medicine, and no escape. A handful of survivors hide in their separate lairs, until their resources are depleted and then they flee on foot, at first alone, stealing and foraging for food, trusting no one, and learning to kill. Surviving. The story takes place in Year 20 after the collapse with frequent visits to the past. 

Without realizing it, the protagonists are all connected to Arthur– his ex-wives, young son, best friend, a child actor, the paramedic who tried to resuscitate him at the theatre. Older people remember and mourn the “before time” and its marvels that are lost, perhaps forever. In oppressive heat, a troupe of musicians and actors, called the Traveling Symphony, moves from place-to-place around the Great Lakes, performing music and Shakespeare’s plays because “survival is insufficient.” Usually, they bring pleasure and diversion. But they must take care, as some villages are led by cult-like prophets, intent on control by theft, rape, and murder. Only at the end do they reach Severn City, where a fledging community has created a semblance of peace and respect in an abandoned airport with a museum devoted to all that is lost.

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Annotated by:
Glass, Guy

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

When Rachel Aviv, the author of Strangers to Ourselves, was six years old, she simply stopped eating.  She said she got the idea from the Yom Kippur fast.  She was promptly checked into a psychiatric hospital where she became one of the youngest-ever patients to be given the diagnosis of anorexia.  Through associating with older, more seasoned anorexic girls she became a sort of “anorexic-in-training” (p.13). Fortunately, after a few months she snapped out of it, and was discharged.  She never suffered from the same symptoms again.   

As an adult, Aviv began to think about what had happened to her.  The only remnant of her experience was a diary entry from age 8: “I had a diseas called anexexia” (p.231).  Had she even had the disorder, or had the diagnosis been a mistake?  Why had she not gone on to have “an anorexic ‘career’” (ibid.), while one of the girls who had mentored her ultimately died of anorexia-related causes?   In order to answer these questions for herself, Aviv meets with the therapists who treated her more than thirty years ago as well as with the family of her deceased copatient.   

As a result of Aviv’s introspection, she becomes intrigued by people whose psychiatric diagnoses do not fully capture the complexities of their situation.  Strangers to Ourselves presents detailed case histories of several such individuals.  Bapu is an Indian woman whose visions have caused her to be diagnosed with schizophrenia.  Are they delusions, or is she a mystic?  Naomi is a socially disadvantaged black woman who has struggled unsuccessfully to get ahead.  During a manic episode, she jumps into a river with her young twins, one of whom dies. Her claim that “white people are out to get me” (p. 146) is ignored because her doctors insist that “delusions couldn’t on some level make sense” (p. 150). Yet another woman, Laura, bounces from diagnosis to diagnosis, and sleeps fourteen hours a day because of all the medication she is on.  She becomes one of these people who no longer even know if their lack of functioning is “due to their underlying disorder [or] the heavy medications they’d taken for it” (p. 203).      

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Hurdy Gurdy

Wilson, Christopher

Last Updated: Oct-14-2022
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Brother Diggery, formerly called Jack Fox, tells us that he was given to the monastic order of St Odo at the age of seven in 1341. For another seven years, he is raised in innocence within the strict rules of the community, serving the brother healer, learning herbal remedies, and playing the hurdy gurdy.  

As plague arrives in 1349, he is assigned to help care for the anticipated sick – and immediately falls ill. The brothers seal him inside his cell, where he suffers greatly, narrowly escaping death; however, when he recovers and forces himself out of confinement, he discovers that everyone else has died or fled. After filling a mass grave with the remains of his brothers, he sets out on a picaresque series of adventures, blithely unaware that he and his fleas spread illness wherever they go.  

Like a fourteenth-century Candide, Brother Diggery’s gullibility and curiosity lead him to discover the wonders of good food, sex, and marriage, the cruelty of lies, theft, and wrongful imprisonment, and the corruption of the church (p. 164). He closes his account in 1352, age 18, already twice widowed, but set for life as a lay physician and father of a young boy whom he plans to give to the monastery of St Odo when he reaches age seven.



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Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

In The Unseen Shore: Memories of a Christian Science Childhood, Thomas Simmons narrates the physical, emotional, and spiritual anguish of growing up in, and later leaving, the Christian Science Church. “Have I escaped now? Enormous question—who knows?” writes Simmons, “The obvious answer is Yes, of course I’ve escaped. I now go to doctors; I no longer lie for helpless hours in bed, writhing and trying to pray” (5). Christian Science teaches that illness and pain are illusions of an unreal material world, and that human suffering can be healed through prayer. As the founder of Christian Science, Mary Baker Eddy, wrote in Science and Health with Key to the Scriptures, "Sin, disease, whatever seems real to material sense, is unreal in divine Science" (353). Simmons explains how this theological indoctrination distorted his view of the material world, morality, and the human body: “I remember very clearly several occasions when Sunday school teachers would warn us that medical doctors were not to be trusted because the world they believed in was not our world—it was the world of mortal mind, of disease and distress” (4). Simmons wavers uneasily between apostasy and piety, questioning if he should trust his physical, bodily senses (“mortal mind”) or the numinous promises of Divine care. As he grows up practicing Christian Science, suffering untreated ear infections and other illnesses, he struggles to maintain a posture of devotion while coping with spiritual misgivings.

These “tremors of doubt”, however, haunt Simmons beyond childhood into his adult years (106). Yet two powerful experiences draw him away from Christian Science: the study and composition of poetry and “the love of bodies” (67). In need of a different kind of spiritual direction, Simmons turns to poets whose works celebrate the beauty of the concrete world, realizing that “. . . I want the world, want its physical hardness and qualities of light and sound, the depths of its touch and soul. In the words of poets and teachers I see my own path back into that world” (129). Another key incident occurs following a bout of spiritual renewal when Simmons interviews to become a Christian Science practitioner (a kind of minister who prays for ailing Church members). Stopping to savor the beauty of the California coastline, he hopes the gorgeous expanse will reveal a divine sign affirming his spiritual ambition. He receives an altogether different omen, however, one he considers mockingly lewd, in the form of a naked man exercising on the beach below where he sits: “And yet I could not quite leave. For a few seconds I watched this man run. Far from admiring the precision of his muscles or the stillness of his torso as he moved his legs, I rejected them: they could hold no sway over me, for they were not real. But they remained interesting in their unreality” (156). (Readers might imagine this nude interloper as Vesalius’s anatomical man from De humani corporis fabrica [1555], who stretches and moves with certainty, exhibiting the magnificent brawn and sinews of the human form.) In this moment, Simmons's spiritual optimism almost vanishes, unnerved by the physically real, naked human materiality in which he will ultimately find solace and beauty.

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The Way of All Flesh

Parry, Ambrose

Last Updated: Oct-04-2022
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Will Raven is a medical student beginning his apprenticeship with Dr James Young Simpson. He has been involved with a prostitute Evie whom he finds murdered. Simpson’s housemaid, Sarah Fisher, takes a dislike to him, not least because of his educational and social privileges. She is barred from such opportunities because of her gender and class, despite her greater intelligence. Sarah studies medicine on her own. Coming from poverty, Raven is nevertheless, pompous, chauvinistic, quick to fight, and desperate to earn money and status. 

Like Evie, other young girls are being brutally murdered in the Old Town of Edinburgh, and Raven and Sarah are separately motivated to find the killer. Their master, Simpson, is conducting experiments with anesthesia and suspicions are cast upon him. Although Raven and Sarah are part of his household, they find his behavior mysterious. Eventually they collaborate to solve both mysteries.

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Wayward: A Novel

Spiotta, Dana

Last Updated: Sep-29-2022
Annotated by:
Trachtman, Howard

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Dana Spiotta is one of my favorite authors, so I was poised to read her latest novel, Wayward, when it was published last year. As expected, it captures the zeitgeist perfectly and is marked by Spiotta’s wide-ranging wisdom, versatile knowledge, and literary creativity.

The book takes place in Syracuse shortly after the election of 2016 (although Donald Trump is never mentioned by name). Sam, the central character in the novel, feels caught in an increasingly unsatisfying marriage. Triggered by her post-election anxiety, she abruptly decides to leave her husband  Matt and daughter Ally. On a whim, she purchases a rundown old-style house in a poor neighborhood in Syracuse and moves in to live as a 53-year-old woman on her own, intent on starting a new life. Matt is disconcertingly understanding and supportive, but Ally cannot abide her mother’s abandonment of the family. It is an unwanted distraction from her single-minded devotion to excel in high school and to go to a top-tier college.

Sam works as a volunteer near her new home at a historical site that is dedicated to Clara Loomis, a fictional woman who left her family (shades of Sam!) to join the Oneida community, an egalitarian retreat based on equality between the sexes but also fuzzy notions of eugenics and human breeding. Sam works her way through some edgy women’s groups in search of friendship. She tries to mingle with her neighbors, who are quite different than the people she encountered in her suburban environment. But Sam’s life is complicated. She realizes that her mother, a self-sufficient creative 80-year-old woman, is probably dying from an undisclosed illness. She feels increasingly distant from the daughter that she loves so intensely, a  problem that her defection to the inner city has only made worse. And Ally has her own precocious story, a secret life, which is told from her perspective, but which is tightly linked with her mother’s narrative of inner growth.

Sam witnesses a police shooting of a Black adolescent, an immigrant from Somalia, while walking near her house during a restless night. While Sam struggles to find a way to articulate what she saw and help achieve some degree of justice for the victim, she experiences an unexpected “assault.” No spoiler alert, except to say that the ending gathers the narrative stands together and is quite satisfying. It is grand in scope and affirms the value of simple human endurance.

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Summary:

Andrew Mangham’s The Science of Starving in Victorian Literature, Medicine, and Political Economy examines how Victorian writers drew upon the era’s medicine and physiology to represent the physical realities of starvation. Wondering readers, at first glance, might ask if starvation can be described in any terms other than a physical experience; however, Mangham argues that prevailing nineteenth-century political economy theorized population growth and food scarcity in ways that radically obscured the corporeal suffering wrought by starvation. Undergirding Victorian-era political economy was the influential work of the British cleric-economist, Thomas Malthus, and the rise of statistics. Malthus’s well-entrenched theories maintained that starvation, or large-scale famine, was a natural (and therefore inevitable) response to overpopulation. “In Malthus’s thinking,” Mangham clarifies, “hunger is the greatest tragedy in human economics: in the worst of times it rises up as a horrible check on those nations whose resources have been overrun by improvident birth rates” (1). These theories further solidified within religious contexts, which produced the peculiar notion of “salutary starvation” (26) or “the providential law of starvation” (30)—an understanding of famine and other disasters as just consequences for exceeding the material capacities of God’s “natural system” (26). Malthus’s theories, imbued with religious interpretations, were pernicious and far-reaching, seeping into how the British government and affluent classes viewed and (mis)understood poverty. Mangham also maintains that Malthus’s theories were augmented by the emergence of statistics during the first several decades of the century, which enabled the government to measure and evaluate epidemiological patterns, demographic data, and other information about human populations (53). He notes that while statistics were used to collect data about starvation, the data were frequently presented in ways that skewed the prevalence of malnutrition, food scarcity, and diseases and mortality rates related to starvation (56). Using a range of literary and primary sources, Mangham underscores that support for statistics was far from monolithic, that for all the scientific certitude that government officials invested in the discipline, there were critics who vociferated about how statistics were often reductive representations of human experience. In other words, masses of tabulated numbers created a cold, mathematical distance between government authorities and those human lives suffering starvation (56–57). Overall, Mangham outlines a bleak picture of Victorian political economy and its views of material privation.

For Mangham, then, one of the most injurious consequences of political economy was its failure to observe starvation (and its manifold health complications) as a material, indeed physiological, experience. As noted, political economists viewed starvation as anything but a form of bodily suffering, using theories instead to explain the naturalness and necessity of hunger and thus blaming the poor, not government and industry, for their problems (31). While political theorists were preoccupied with these explanations, Mangham traces the era’s concurrent developments in medicine that examined the physiology of hunger and digestion. The gastrointestinal research of Italian Lazzaro Spallanzani influenced Victorian physicians, namely John Hunter, Charles Thackrah, George Henry Lewes, Thomas Southwood Smith, and others, who sought to describe the anatomical workings of the stomach and explain the bodily sensations of hunger (36). Against this backdrop, Mangham argues that Charles Kingsley, Elizabeth Gaskell, and Charles Dickens—united in their “antipathy towards Malthusianism” (17)—recognized the power in articulating starvation using physiological terms, and turned to science to limn “. . . the material sufferings of the starving and, more importantly, on detailed analysis of what it means to go hungry and to observe and to write about it in a way that seeks to be truthful” (16). In chapters that individually examine each author’s literary works, Mangham demonstrates how “. . . physiological ideas offered both an alternative way of thinking about hunger and an exploration of the ways in which it might be interpreted” (47). This volume’s close readings of these authors’ various novels, journalism, and speeches reveal that medical science offered a language that could undermine theories that misunderstood human starvation and the sociopolitical conditions that perpetuate it. Kingsley, Gaskell, and Dickens used new science to depict not only physiologically accurate but humanized renderings of the poor.

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Stuck

Larson, Heidi J.

Last Updated: Sep-20-2022
Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Medical Anthropology

Summary:

Stuck was published shortly before the Covid pandemic when the American vaccine wars, with all their hostility, misinformation, and political baggage, lay more than a year in the future. In Stuck, Heidi J. Larson, Professor of Anthropology and Director of the Vaccine Confidence Project at the London School of Hygiene & Tropical Medicine, approaches vaccine rejection as a complex moral and cultural phenomenon, rather than as a simple issue of ignorance or a marginal point-of-view. In a sense, anti-vaccine rumors are the tip of an iceberg, reflecting and perpetuated by deep underlying concerns, like perceived threats to personal or cultural values, distrust of government, misperception of risks and benefits, or a combination of these. The claim that compulsory immunization violates personal freedom is especially prominent today.  

Rumor is a major source of vaccine rejection. The author discusses in detail the case of Andrew Wakefield and his contention that MMR (measles, mumps, rubella) vaccine causes autism. This belief, based on a 1998 paper in The Lancet (later retracted) has been shown to be false by numerous large-scale studies, but is accepted by perhaps millions of people throughout the world.  

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