Showing 471 - 480 of 759 Nonfiction annotations
This is an ambitious and far-ranging book, the result of years of thinking, teaching, and working with patients. An internist at the College of Physicians and Surgeons at Columbia University, Charon sees a wide range of patients in an urban setting. Also a Ph.D. in English literature, Charon has devised a "Parallel Chart" and other means for caregivers to write personally about the dynamics between healer and patient, to read texts--narratives in particular--and, as a result, to listen better to patients, thus improving the delivery of medical care.
Charon defines narrative medicine as "medicine practiced with these skills of recognizing, absorbing, interpreting, and being moved by the stories of illness" (4). She calls this a "new frame" for medicine, believing that it can improve many of the defects of our current means of providing (or not) medical care. Caregivers who possess "narrative competence" are able to bridge the "divides" of their relation to mortality, the contexts of illness, beliefs about disease causality, and emotions of shame, blame, and fear.
Charon finds that medical care and literature share five narrative features; she argues that careful reading of narratives builds skills that improve medical care, including intersubjectivity between caregiver and patient, and ethicality. Beyond the theory, there are powerful and persuasive examples of interactions between caregiver and patient, many from Charon's own practice. A mother of a sick daughter experiences stress that makes her ill; when she sees a narrative connection, she begins to heal.
Charon sees wider applications. As caregivers understand better concepts of attention, representation, and affiliation, they become more ethical, more community minded, and better healers to their patients. Patient interviews will be different: instead of following a grid of questions, physicians will converse with patients in an open-ended way. What is most important will emerge and emerge in ways that are most beneficial to the patient. Yes, this method will take more time but it will be more efficient in the long run. Bioethics, Charon argues, has been limited by legal approaches and philosophical principles. For her, narrative bioethics offers more human values in how people feel, experience reality, and relate to each other. Finally, there are implications for social justice: why are the poor underserved in this country and in many others?
One of the most exciting and radical formulations comes late in the book: ". . . practitioners, be they health care professionals to begin with or not, must be prepared to offer the self as a therapeutic instrument" (p. 215). This notion links up fruitfully with concepts of energy medicine (v1377v), therapeutic touch (Tiffany Field), and intentionality (Wayne W. Dyer).
Born in 1728 the tenth child in a struggling Scottish farm family, John Hunter was a wayward and unteachable child who spent most of his time outdoors. At the age of 20, with no prospects and having lost his father and 6 siblings, he wrote for help to his older brother William, who was practicing midwifery in London and had just opened England's first anatomy school, one featuring the revolutionary opportunity for students to dissect their own cadavers.
John rode the 400 miles to London on horseback, apprenticed with great success under William, learned dissection, then surgery, and went on to become a supremely gifted anatomist and surgeon, one whose brilliant and tireless experimentation broke with ancient and outmoded medical traditions and established the foundation for modern science-based surgery. (When John arrived in London, the city's Company of Barber-Surgeons had only just dissolved to allow surgeons to organize themselves independently of barbers.)
One of his most important activities in working for his brother--and which continued when he made his own way--was the procuring of cadavers, which because of the customs of the time involved him intimately in the grisly business of grave-robbing.
Shannon Moffett, a medical student at Stanford University School of Medicine, became fascinated with the brain during her anatomy and neurobiology courses. She set off across the country to interview people--scientists, doctors, patients, ethicists, and religious leaders--who devote their careers trying to understand the brain and cognition. With infectious enthusiasm and energy, Moffett brings the reader to meet these dedicated people, their work, their theories and their lives.
The book contains eight chapters and hence eight mini-biographies: 1) neurosurgeon Roberta Glick, 2) cognitive neuroscientist and brain imagist John Gabrieli, 3) Francis Crick (of DNA double helix fame) and Christof Koch--scientists studying consciousness, 4) sleep researcher Robert Stickgold, 5) Judy Castelli who has dissociative identity disorder (multiple personality disorder), 6) philosopher Daniel Dennett, 7) neuroethicist Judy Illes, and 8) Zen monk Norman Fischer.
Separating the chapters are "interludes" that map neural and brain development from conception to death. The book has a reference list for each chapter and a complete index, as well as a web resource (www.shannonmoffett.com) to which the reader is directed for graphics.
The writing is compelling, direct, fresh and insightful. For example, in "Touching the Brain," we follow the exhausting lifestyle of an academic neurosurgeon who works at Cook County Hospital in Chicago as she performs surgery, teaches, attends services at a temple, drives her car, takes care of her family including two young children, rounds on patients, hosts a potluck dinner, and simultaneously discusses her reading, travel and spirituality.
Moffett aptly describes Glick with her "waist-length red hair, ... beaten-metal earrings dangling almost to her shoulders and a saffron batik dress" as someone you'd "expect to find reading storybooks to kindergartners in a public library" (8). In fact, it is Moffett's eye for accessible detail that makes not only the people, but also neuroscience come alive. Artfully woven into the text are lessons on the history of brain research and current understanding (and questions) about the brain, its meaning and function.
Howard Carter very skillfully weaves together the various meanings that the heart holds for us--biological, medical, psychological, cultural, and spiritual. He does so through four patients that he interviewed when he was appointed to a distinguished professorship in medical humanities in a joint program of St. Patrick Hospital and the University of Montana, in Missoula.
Each of the sections of the book focuses on one of the patients who suffers, respectively, from a prototypical heart problem: a young man with congenital defects who undergoes successful surgery; a middle-aged woman with a viral illness who learns how to live with her chronic heart condition; a middle-aged man whose blocked coronary arteries are cleared, as is the stress in his life; and an old man who turns to spiritual matters as he faces heart failure.
What contribute significantly to the uniqueness of this book are the essays that Carter provides at the end of each Patient Section. They are the vehicles for the synthesis of the patient stories, the scholarly look at how "we have largely lost the anchoring image of the heart" in American society, and his very poignant personal reflections about life in (or at least near) the wilderness of Montana. (See Solid Footing, Higher Ground -Third Essay as an excellent example of his skillful and moving writing.)
This biography begins on April 20, 1995 when the ashes of Marie and Pierre Curie were transferred from their graves in a Paris suburb and re-interred in the Pantheon, thereby placing the Curies among the "immortals" of France. Thus, Marie became the first (and so far the only) woman to be honored in this way. Goldsmith's biography is a straightforward and well-written narrative that eschews hagiography, wordiness, and psychological interpretations.
The story of Marie Curie (1867-1934) is well known. Born into an intellectual but impoverished Polish family, she struggled to obtain a scientific education, first in Poland and then at the Sorbonne in Paris. While a graduate student, she met and married the young chemist Pierre Curie. Together, with essentially no funding and dismal laboratory space, they discovered and characterized radioactivity. Later, on her own Marie discovered and isolated two new elements, polonium and radium. Subsequently Marie and Pierre created the Curie Institute, where Marie was in the forefront in envisioning medical applications of radioactivity and radium.
The story is especially powerful in its depiction of bias against women in science. Marie had to fight for many years to obtain a faculty position at the Sorbonne (unheard of for a woman), or even space to conduct her experiments. When the Nobel Committee awarded its 1903 Prize in Physics, Pierre had to fight to have his wife included in the citation, even though the bulk of the brains and energy behind the discovery of radioactivity were clearly Marie's. Marie was later vindicated when she won her second (and solo) Nobel Prize in 1911 for the discovery of radium.
Obsessive Genius doesn't shy away from Marie Curie's recurrent clinical depressions, which began during her adolescence, nor from her obsessive, hard-driving personality. The book presents an even-handed picture of repeated conflict between her love of her husband and children (one of whom, Irene Joliet-Curie, in 1935 became the second woman scientist ever to win the Nobel Prize); and her passion for her work.
This concise and well-written biography is meant to be, as Sherwin Nuland tells us, "a guide for the perplexed," for those who may recognize the name of Maimonides and his historical importance to Jewish religion and culture, or who may even have read some of his works, but have no knowledge of the man behind the name. The story begins, as it should, in Medieval Spain with its vibrant Judaeo-Islamic culture, in which the historical relationship between Judaism and medicine developed and later expanded throughout the European and Islamic worlds. Though they were outsiders in both civilizations, Jewish physicians became the most sought after healers in the Christian and Muslim worlds.
Moses son of Maimon (also known as Maimonides and the Rambam, 1138-1204) was born in Cordoba, the cultural and political center of Muslim Spain. He and his family had to flee Cordoba to avoid persecution in 1148. They wandered through Spain until 1160, when they settled in Fez, Morocco. Again fleeing from persecution, Maimonides moved to Fustat, Egypt, when he was 30 years old and remained there for the rest of his life. During these early years, the young rabbi wrote numerous biblical commentaries, culminating in the Mishneh Torah, his great code of Jewish law. Later, he attempted to reconcile faith with reason in another great work, The Guide for the Perplexed, completed in 1190.
Maimonides's specifically medical work is difficult to characterize and evaluate. The traditional historical assessment is that he was "unique in his time in the theory and practice of medicine." Essentially, he practiced Galenic medicine, as transmitted and developed in the flourishing Islamic tradition. We don't know how he acquired his medical knowledge, but by the time he reached Fustat, Maimonides was acknowledged to be a leading physician and in 1190 he was appointed personal physician to the vizier of Egypt. Late in life, Maimonides wrote a number of medical treatises, most importantly his Medical Aphorisms, which presents a coherent, well-organized, and practical medical system based on Galen and Aristotle.
Elisabeth Kubler-Ross was born in Switzerland in 1926. She was part of a package deal--a triplet (and a two-pounder at that). That she survived the birth (as did her two sisters, another two pounder and a more robust six pounder) is something of a miracle. As she explains, her early childhood was filled with other more memorable experiences around death as well, including a long battle with pneumonia and deathbed scenes of neighbors in her small town.
In the aftermath of World War II, she was a volunteer in IVSP, International Voluntary Service for Peace. She spent time in Poland and then Germany, aiding survivors of the concentration camps, as well as the defeated Germans, to rebuild their lives. She returned to Switzerland and went to medical school, eventually marrying an American student studying there.
After practicing as a small town family doctor, she came to the U.S. in the 1950s. Her plans to serve a residency in pediatrics were changed to psychiatry (because they didn’t want someone who was pregnant). In Denver, after residency, she was asked to lecture to medical students. She chose a topic that was out of the ordinary, but something she felt at home with--death and dying.
In 1965, in Chicago, she continued her work in this area. At the urging of some theology students she began a weekly seminar with dying patients, health professions students, (and eventually ) their more skeptical teachers. This experience led to the publication, in 1969, of her book, On Death and Dying. It is in this book that the "stages" of dying are discussed. The remainder of The Wheel of Life deals with more controversial aspects of Kubler-Ross’s life.
Summary:At 23 years old, James is brought by his parents to a drug and alcohol rehabilitation center in Minnesota to get treatment for his alcoholism and drug addictions. Physically and emotionally shattered, he slowly recuperates, sometimes insistently conquering his addictions with his own willpower, and at other times with the help of those around him. The consequences of his addictions, his struggle against the platitudes of the Twelve Step programs, and his relationships with his counselors build the tension in the book; his relationship with his family and several of his fellow addicts forms the heart of it.
Note that this annotation contains spoilers. The sequel to A Million Little Pieces (see this database), Frey's follow-up memoir begins with James serving time in an Ohio prison for crimes he had committed while an addict. On his release, he goes to Chicago where he plans to reunite with his girlfriend, Lilly, and start a new life. As soon as he arrives at the halfway house where she was living, he discovers that she had committed suicide the night before. Shattered again, he tries to establish himself in Chicago without relapsing (with notable bravado: working as a bouncer in various bars).
His friend and "father" Leonard, a mobster who unofficially adopted him during their stint in rehab together, as chronicled in A Million Little Pieces, tries to help him get on his feet financially. After a period as a runner for the mob, James decides to move to Los Angeles to become a writer, with some success. Leonard remains a benevolent father-figure and as their friendships develops, the larger-than-life Leonard and his mob henchman meet James's friends, his family, his girlfriends, even his girlfriends' families--until Leonard disappears. James eventually locates Leonard, and discovers that Leonard is gay, has AIDS, and the two of them spend Leonard's last few days together.
Joan Didion has written a very personal, powerful, and clear-eyed account of her husband's sudden and unexpected death as it occurred during the time their unconscious, hospitalized daughter was suffering from septic shock and pneumonia.
Quintana, the couple's 24-year-old adopted child, has been the object of their mutual care and worry. That John Gregory Dunne, husband and father, writer and sometime collaborator, should collapse from a massive, fatal coronary on the night before New Year's Eve at the small dinner table in their New York City apartment just after their visit with Quintana can be regarded as an unspeakable event, beyond ordinary understanding and expression. "Life changes fast . . . in the instant. You sit down to dinner and life as you know it ends" (3).
As overwhelming as these two separate catastrophes are, the account provided by Didion evokes extraordinary descriptions of the emotional and physical disorientations experienced by this very lucid, but simultaneously stunned and confused wife, mother, writer dealing with the shock of change. Her writing conveys universal grief and loss; she spins a sticky filament around the reader who cannot separate him or herself from the yearlong story of difficult, ongoing adjustment.