Friday, January 24, 2020

Willa Cathers Death Comes to the Archbishop: A Narrative :: Willa Cathers Death Comes to the Archbishop

Willa Cather's Death Comes to the Archbishop: A Narrative Though many reviewers of Willa Cather's, Death Comes to the Archbishop, had difficulty classifying the book, Cather herself preferred to call it a narrative rather than a novel. I tend to agree with Cather. One definition from Webster's New World College Dictionary defines "narrative" as "a story", which is then defined as, "the telling of a happening or connected series of happenings, whether true or fictitious". A novel on the other hand is defined as having, "a more or less complex plot or pattern of events." Where most books tend to follow certain guidelines as to plot, Cather chooses to take a different route. Trying to create a tale that involves clever plot twists, bizarre characters, a telling climax, and a fitting denouement, would detract from the simple story she is telling. It is the story of two French priests who have been sent to the American Southwest to rejuvenate the Catholic churches in that diocese, during the late 1800's. The southwest, during this time period, was harsh and unhurried, and its indigenous people lived simple, remarkable lives. In keeping with the atmosphere of her story, the book is written almost as though her two main characters are keeping journals. The stories of Bishop Latour and Father Vaillant, who have adopted this rugged lifestyle, are told in little vignettes separated by chapters. Each vignette narrates a meaningful incident in their lives. I find it interesting that each chapter, or vignette, can stand on its own as an independent short story, yet it is woven together to create a tapestry of the Father's lives, with the people they meet and places they go tying it all together. Cather put it best when, in the book, she says, "Observing them thus in repose, in the act of reflection, Father Latour was thinking how each of these men not only had a story, but seemed to have become his story" (182). This type of "narrative" writing gives believability to the people, and a sense of realism to the story.

Thursday, January 16, 2020

Hillcrest Case 7 Operative

OPERATIVE REPORT Patient: T. J. Moreno Patient ID: 110497DOB: 02/15Age: 44Sex: M Date of Admission: 10/09/2013 Date of Procedure: 10/09/2013 Admitting Physician: Patrick Keathley, MD Endocrinology Surgeon : Dr. Max Hirsch, MD Orthopedics Assistant: Markus Leroy Johnson PAC (Surgical assistant was used for soft tissue protection and retraction and also for maintaining reduction during temporary and permanent fixation use of surgical assistant was medically necessary, and to prove the safety and efficacy of the procedure. Preoperative Diagnosis: Left hindfoot osteoarthritis. Postoperative Diagnosis: Left hindfoot osteoarthritis. Operative Procedure: 1) Triple arthrodesis . 2) Popliteal sciatic block placed by surgeon explicitly for postoperative pain management. Anesthesia: General by Chuck Delaney, MD. Condition during anesthesia, stable. Specimen Removed: Nine. IV Fluids: See nurse’s notes. Estimated Blood Loss: See nurse’s notes. Urine output: See nurse’s notes. Complications: None. Postoperative condition: Stable (Continued) OPERATIVE REPORT Patient: T. J. MorenoPatient ID: 110497DOB: 02/15Age: 44Sex: M Page: 2 INDICATION: A 44 year old male with hindfoot osteoarthritis pain, who has failed conservative management after reviewing risks, benefits and alternatives, he has agreed to proceed with surgical management. Risks of delayed healing, non-healing and infection, nerve vessel tendon injury, ongoing pain and discomfort, procedure failure, need for revision surgery, and/or hardware removal noted. The fact that he will have a stiffed hindfoot noted. Patient’s questions were answered, and he was consented for the planned procedure.PROCEDURE IN DETAIL: The patient was taken to the operating room where general anesthesia was induced. Time out was taken indicating the appropriated site, procedure, and patient. Operative site was initialed, one gram of Ancef given IV. Popliteal block was placed medial to lateral hamstring, 3 fingerbreadt hs proximal flexion crease to the knee. Intraneural injection of avoided by reducing the amperage to below 1 milliamp, seeing an obliteration of motor response. The extremity was prepped and draped in the usual fashion. Extremity exsanguinated, tunicate inflated.No equinus was present. Metier incision made from the tip of the fibula to the base of the fourth metatarsal. Extensor digitorum brevis and fat pad were elevated off the inferior peroneal retinaculum. Calcaneocuboid and subtalar joints were carefully exposed, denuded of cartilage, and prepared with a 4mm osteotome for arthrodesis. The calcaneocuboid joint was exceptionally osteoarthritic. The talonevicular joint linear incision was made in line with the posterior tibial course, sharp dissection carried down through skin with blunt dissection of subcutaneous tissues.Saphenous vein was retracted in a dorsal postion, linear incision made in the periosteum. The calcaneo and the talonavicular joint were carefully exposed. Cartill age, or what was remaining of cartilage was removed. There were extreme osteoarthritic thoughout. Essentially 5%-10% of cartilage remained. The osteophytes were carefully excised with osteotome, the joint was prepared with microfracture using an osteotome on both sides of the joint. (Continued) OPERATIVE REPORT Patient: T. J. Moreno Patient ID: 110497DOB: 02/15Age: 44Sex: M Page: 3Shortly the incision made off the weight bearing surface of the posterior heel. Guide wire from the 70 cannulated set was advanced across the posterior heel across the subtalar joint into the talor neck body junction. This was done while the heel was held in a slight valgus position. After verifying position and measuring, the wire was advanced to the anterior ankle, held with a hemostat. This was followed by sequential reaming with 4. 0 and then 7. 0 cannulated reamers. Next, after tapping, a fully threaded 100 mm screw was placed over a washer. Care was taken to avoid soft tissue impingement posteriorly. Excellent compression, fixation, subtalar joint were obtained without impingement of the ankle. Next the talonavicular joint was reduced to a foot plantar grade position, held with two 4. 0 cannulated screws starting at the naviculocuneiform joint. Next the calcaneocuboid joint again was adjusted to allow for plantar grade foot position. The joint was held with 4 staples from the 3M 15X16mm stabilizer. All wounds were irrigated with normal saline, excellent compression was present in each position, the medial periosteal was repaired with 3. 0 vicral suture.Subcutaneus tissues closed with 3. 0 vicral and skin closed with skin clips. On the lateral side, extensor digitorum brevis was repaied to the inferior peroneal retinaculum as was the fat pad. Subcutaneous tissue was closed with 3. 0 vicral. Skin closed with 4. 0 nylon. The posterior heel was irrigated and closed with 4. 0 nylon suture. A sterile dressing was applied plus telfa dressing, sponge, Webril, cotton roll, and plaster sp lint. The foot was at a final plantar grade position. Image intensification showed well placed hardware, extra articular to the ankle.Patient was taken to the recovery room in stable condition with no known complications. POST-OPERATIVE PLAN: The patient will be observed overnight with pain control maintained. Once he is surgically stable, patient will be transferred to endocrinology for evaluation and care of his newly diagnosed diabetes and hypertension. He is to follow up in my office in one week for wound check. _______________________________________________________________ Max L. Hirsch, MD Orthopedic Surgery mh/xx D: 10/15/20 T: 10/15/20

Tuesday, January 7, 2020

The Storm Essay - 1031 Words

The Storm In Kate Chopin’s short story â€Å"The Storm†, the narrative surrounds the brief extramarital affair of two individuals, Calixta and Alcee. The story does not seem to be as a condemnation of infidelity, but rather as an affirmation of human sexuality. â€Å"The Storm† may be interpreted as a specific affirmation of feminine sexuality and passion cojoined with a condemnation of its repression by the constraints of society. Even though the adultery considered a crime at that period of time, the storm allowed a moment. The title of â€Å"Storm†, with its obvious connotations of sexual energy and passion, is of course critical to any interpretation of the narrative. Its title refers to nature, which is symbolically feminine; the storm can†¦show more content†¦Alcee only helps her to keep the storm out, and therefore the storm of sexual passion in. â€Å"She was a little fuller of figure than five years before when she married; but she lost nothing of her vivacity. â€Å"Her blue eyes still retained their melting quality; and her yellow hair, disheveled by the wind and rain, †¦Ã¢â‚¬ . The author’s purpose in describing Calixta, then, is to clearly link the protagonist to sensuality and passion, to the very elements of the symbolism of the storm. The storm outside continues to increase, reflecting the sexual tension inside. Calixta and Alcee move through the rooms of the house until they are adjoining Calixta’s bedroom, and we see the lack of passion in marriage represented by the separate beds that Calixta and Bobinot have. The room’s description also hints at the mystery of passion: â€Å"The door stood open, and the room with its white, monumental bed, its closed shutters, looked dim and mysterious†. The images in the bedroom seem to contrast one another, the white purity of innocence versus the dark mystery of sin. Calixta begins to gather up a cotton sheet that she has been sewing, in effect putting away a symbol of society’s constraints. The passion of the storm echoing her inner emotions, and when the lighting strikes nearby, Calixta staggers backward into Alcee’s arms, and for a moment he draws her â€Å"close and spasmodically to him†. â€Å"†¦ when he had unthinkinglyShow MoreRelatedThe Storm Essay1033 Words   |  5 Pageswords to describe our exultation. We watched the sky in awe as clouds rolled by. Just then, Daniel, who was naturally anxious about practically everything, spotted a group of storm clouds approaching menacingly towards our position. Stop being so worried, its just some minor storm clouds, theyll pass, I said trying to comfort him. He was a fantastic climber and companion, but easily traumatised. The clouds did look slightly perilous, and my slight trepidationRead More The Storm Essay723 Words   |  3 Pages The Storm The title of this story suggests a metaphorical connection between the storm outside and the storm of emotions going on in the individuals Calixta and Alcee. The intensity of their sexual act inside the house follows the pattern of the storm outside. Their passion climaxes and diminishes with the storm. They are left replenished and fresh just like nature. The storm outside had been brewing for some time, just as it had been brewing between Calixta and Alcee. They tried to deter theRead MoreEssay on A Storm of Emotion in Kate Chopins The Storm817 Words   |  4 PagesThe Storm of Emotion Usually a storm creeps upon us, hits a luminous climax, and then fades away into nothingness.   In The Storm, Kate Chopin develops a parallel between a rainstorm and an emotional storm in a woman’s life.   Chopin uses symbolism to depict the feelings of relationships that are as unpredictable as that of a raging storm.   Ã‚  Ã‚   In the time frame that this story is set, many major life decisions things are made taking into account one’s duty to family - including theRead MoreEssay The Storms of Villette1019 Words   |  5 PagesThe Storms of Villette      Ã‚   In Charlotte Brontà «s novel, Villette, Brontà « strategically uses the brutality and magnitude of   thunder storms to propel her narrator, Lucy Snowe, into unchartered social territories of friendship and love. In her most devious act, the fate of Lucy and M. 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They wereRead MoreThe Storm by Kate Chopin1332 Words   |  6 Pages The first thing I noticed about Kate Chopin’s â€Å"The Storm,† is that it is utterly dripping with sexual imagery and symbolism. Our heroine, if you will, seems to be a woman with normally restrained passions and a well-defined sense of propriety, who finds herself in a situation that tears down her restraint and reveals the vixen within. I wonder if it was intentional that the name Calixta makes me think of Calypso – the nymph from Greek mythology. If half of the sexual symbolism I found in thisRead MoreThe Storm, Theodore Roethke1336 Words   |  6 PagesRoethke, deals with an aggressive storm and all its effects on the environment: the surrounding nature and the people experiencing it. The storm is described in a disorganized manner to highlight the big chaos the storm causes. Nature is precisely illustrated, because it re acts on the storm and thus is an important factor for the description of the storm. The people simply give an extra dimension to the poem, and the theme of men versus nature in the form of a storm. As the title tells us, theRead MoreFeminine Sexuality in The Storm725 Words   |  3 PagesThe Storm; describes an encounter of infidelity between two lovers during a brief thunderstorm. The story alludes to the controversial topic of womens sexuality and passion, which during Chopins time no one spoke about much less wrote about. So controversial was The Storm,; that it was not published until after her death in eighteen ninety-nine. The story is broken up into five sections, each filled with small clues and hints that reflect her message. In short, Kate Chopins The Storm; is