Showing 1 - 10 of 108 annotations tagged with the keyword "Physical Examination"
Summary:The speaker of this poem is a nurse who is recalling and attempting to come to terms with a disturbing clinical encounter she’d had the week before. (I should note at the outset that there’s no indication in the poem as to whether the nurse is male or female. I choose to think of her as female). What had happened is that a mother had brought her five-year-old son in for treatment, and the nurse’s exam revealed that the child had second- and third-degree burns on his torso—in the shape of a cross. The mother, weeping, confessed that her boyfriend had, as a punishment, applied a cigarette to the child’s body—while the mother had held her son. Seeing the mother’s tears, the nurse considered offering the woman some Kleenex, but could not bring herself to do so. The child retrieved the box of Kleenex, then clung to his mother’s skirt, and glowered at the nurse. Then the nurse had participated with three others in prying the boy away from his mother. In the present of the poem, a week after the encounter, the nurse attempts to deal with the guilt and shame she feels in her failure of professional decorum and compassion—at having failed to rise above her moral judgment against the mother and offer the woman basic human kindness and respect. In confronting the chaos of her emotions, the nurse turns to a story she’d learned in high school: the story of St. Lawrence. The significance of her attempt to think with this story can be overshadowed, for readers, by the intensity of the clinical encounter she recalls; but her endeavor is of at least equal significance as the encounter.
Summary:The collection is prefaced and named for a poem by Walt Whitman, The Wound Dresser, annotated in this database by Jack Coulehan. In “On Reading Walt Whitman’s ‘The Wound Dresser’” Coulehan sees Whitman as a nurse tending the Civil War wounded, and, while using some of the words and language of Whitman’s poem, imagines himself moving forward in that created space of caring for patients: “You remain / tinkering at your soldier’s side, as I step / to the next cot and the cot after that.” (p. ix) The poem introduces us to all the ‘cots’ of the book – where we step from patient to patient, through history and geography, and through the journey of medical training. The book is comprised of 4 sections without overt explanation, although there are 4 pages of Notes at the end of the book with information about select individual poems. In general, the themes of the sections can be described as: 1.) clinical care of individual patients and medical training; 2.) reflections on historical medical cases, reported anecdotes or past literary references; 3.) meditations on geographically distinct episodes – either places of travel or news items; and 4.) family memoir, personal history and the passage of time. Many of the poems have been previously published and a few are revised from an earlier chapbook. Notable among the latter is “McGonigle’s Foot” (pp 42-3) from section 2, wherein an event in Philadelphia, 1862 – well after the successful public demonstration of anesthesia was reported and the practice widely disseminated, a drunk Irishman was deemed unworthy of receiving an anesthetic. Although it is easy to look back and critique past prejudices, Coulehan’s poem teaches us to examine current prejudices, bias and discrimination in the provision of healthcare choices, pain relief and access to care. There are many gems in these 72 poems. Coulehan has an acute sensibility about the variety of human conditions he has the privilege to encounter in medical training and clinical practice. However, one of the standouts for me was “Cesium 137” based on a news report of children finding an abandoned radiotherapy source (cesium) in Goiania Brazil, playing with the glowing find and suffering acute radiation poisoning. He writes: “the cairn of their small lives / burst open…their bodies vacillate and weaken / hour by hour, consumed by innocence / and radiant desire.” (p. 68). Following another poem inspired by Whitman, Coulehan concludes the collection with a sonnet “Retrospective.” He chronicles a 40-year career along with physical aging, memories of medical training “etched in myelin,” and the search for connection across that span of career including, “those he hurt, the woman / he killed with morphine, more than a few he saved.” Ultimately, he relies on hope with fitting understatement: “His ally, hope, will have to do.” (p. 97)
Summary:In this volume, Gonzalez-Crussi trains his sights on medical history, applying his lyrical writing skills to essays that he hopes will help preserve the humanistic core of the medical profession. Because of its brevity (250 pages), he apologizes for its focus on "Western medicine since the inception of the scientific method"(p.xi), but does note that he acknowledges "the continuity between ancient and modern medicine...[and] the contributions of the Orient, and of epochs predating the dominance of the rational spirit" (p.xi).What distinguishes this volume beyond the writing is the thematic organization. It begins with the Rise of Anatomy and Surgery, but then moves to Vitalism and Mechanism, The Mystery of Procreation, and Pestilence and Mankind, before finishing with a look at Concepts of Disease, The Diagnostic Process and Therapy (including a brief focus on psychiatry). In the last section, Some Concluding Thoughts, Gonzalez-Crussi returns to his motivations for writing this short history, citing the mixed blessings of scientific progress whose gains, for example, are offset by those who "appear to try to 'medicalize' every aspect of human life" (p.210).
Summary:This is the third book in a series on the history of medicine and medical education by Kenneth M. Ludmerer, a practicing physician and historian of medicine at Washington University of St. Louis. The first, Learning to Heal: The Development of American Medical Education, published in 1985, dealt with the history of medical schools and medical education in the US from their origins in the 19th century to the late 20th century. In 1999 he published Time to Heal: Medical Education from 1900 to the Era of Managed Care. This book, Let Me Heal: The Opportunity to Preserve Excellence in American Medicine, published in 2015, is a sweeping history of graduate medical education in the United States from its inception to the current day.
Summary:Samuel Shem's (Stephen Bergman) The House of God, first published in 1978, has sold over two million copies in over 50 countries (see annotation). Its 30th anniversary was marked by publication of Return to The House of God: Medical Resident Education 1978-2008, a collection of essays offering historical perspectives of residency education, philosophical perspectives, literary criticism, and women's perspectives, among others. Contributors include such well-known scholars as Kenneth Ludmerer, Howard Brody, and Anne Hudson Jones, as well as physician-writers Perri Klass, Abigal Zuger, Susan Onthank Mates, and Jack Coulehan. The closing section, "Comments from the House of Shem," includes an essay by psychologist and scholar Janet Surrey (Bergman's wife) and one by "both" Samuel Shem and Stephen Bergman.
Summary:This memoir of a life in medicine takes the writer from St. Louis to a Navajo reservation to Central America to the east coast and from urban hospitals to ill-equipped rural clinics. It offers a wide range of reflections on encounters with patients that widen and deepen his sense of calling and understanding of what it means to do healing work. He learns to listen to tribal elders, to what children communicate without words, to worried parents, and to his own intuition while calling on all the skills he acquired in a rigorous medical education. Always drawn to writing, Volck takes his writing work (and play) as seriously as his medical practice, and muses on the role of writing in the medical life as he goes along.
Summary:Many are familiar with these stories from the author's practice as a midwife among the urban poor in London's East End in the 1950s. Each piece stands alone as a story about a particular case. Many of them are rich with the drama of emergency interventions, birth in complicated families (most of them poor), home births in squalid conditions, and the efforts of midwives to improve public health services, sanitation, and pre- and post-natal care with limited resources in a city decimated by wartime bombings. As a gallery of the different types of women in the Anglican religious order that housed the midwives and administered their services, and the different types of women who lived, survived, and even thrived in the most depressing part of London, the book provides a fascinating angle on social and medical history and women's studies.
Summary:When nine-year-old Rob Cole, child of poor 11th-century English farmers, loses his mother, he is consigned to the care of a barber-surgeon who takes him around the countryside, teaching him to juggle, sell potions of questionable value, and assist him in basic medical care that ranges from good practical first-aid to useless ritual. When, eight years later, his mentor dies, Rob takes the wagon, horse, and trappings and embarks on a life-changing journey across Europe to learn real medicine from Avicenna in Persia. Through a Jewish physician practicing in England, he has learned that Avicenna’s school is the only place to learn real medicine and develop the gift he has come to recognize in himself. In addition to skill, he discovers in encounters with patients that he has sharp and accurate intuitions about their conditions, but little learning to enable him to heal them. The journey with a caravan of Jewish merchants involves many trials, including arduous efforts to learn Persian and pass himself off as a Jew, since Christians are treated with hostility in the Muslim lands he is about to enter. Refused at first at Avicenna’s school, he finally receives help from the Shah and becomes a star student. His medical education culminates in travel as far as India, and illegal ventures into the body as he dissects the dead under cover of darkness. Ultimately he marries the daughter of a Scottish merchant he had met but parted with in his outgoing journey, and, fleeing the dangers of war, returns with her and their two sons to the British Isles, where he sets up practice in Scotland.
Summary:In this collection (80 pages), Marc Straus speaks of the inadequacy of communication and knowledge in medicine; the pauses, the distance, the hesitations. You think you know what you are doing, "But no, they always ask the question / I never knew." ("The Log of Pi") "The question / might be so simple, so clear / that you’re unprepared to answer." ("Questions and Answers") Though words are in one way inadequate, the medical word carries great power: " . . . I knew that moment / I would say one word for her and nothing / would ever be the same again." (One Word, annotated in this database.)The poet comes to understand that he represents both sides of medicine, both the detached and distant Dr. Gold, and the warm and trustworthy Dr. Green. (See annotation of Dr. Gold & Dr. Green) Unfortunately, this knowledge only comes about after the patient has died ("Dr. Gold & Dr. Green, II"). We learn from experience, sometimes too late.
Summary:During the physical examination of an elderly cancer patient, the doctor considers the tell-tale symptoms of pneumonia. While the patient is dying, the physician imagines that the symptoms represent the birth of a universe and that the patient is becoming a part of the galaxy.