Showing 11 - 20 of 433 annotations tagged with the keyword "Professionalism"
Summary:This Side of Doctoring is an anthology published in 2002 about the experiences of women in medicine. While the essays span multiple centuries, most are from the past 50 years. They reflect on a multitude of stages in the authors’ personal and professional lives. In 344 pages divided into twelve sections, including "Early Pioneers," "Life in the Trenches," and "Mothering and Doctoring," the 146 authors recount - in excerpts from published memoirs, previously published and unpublished essays, poems and other writings, many of them composed solely for this collection - what it was then and what it was in 2002 to be a woman becoming a doctor in the U.S.. All but a handful of the authors are physicians or surgeons. There is a heavy representation from institutions on both coasts, especially the Northeast. Four men were invited to reflect on being married to physician wives. There is one anonymous essay concerning sexual harassment and a final essay from a mother and daughter, both physicians. Beginning with the first American female physicians in the mid-19th century, like historic ground-breakers Elizabeth Blackwell and Mary Putnam Jacobi, the anthology proceeds through the phases of medical school, residency, early and mid-careers, up to reflections from older physicians on a life spent in medicine. Many of the authors have names well known in the medical humanities, including Marcia Angell, Leon Eisenberg, Perri Klass, Danielle Ofri, Audrey Shafer, and Marjorie Spurrier Sirridge, to mention a few.
Summary:Very early in this memoir, Dr. Sandeep Jauhar refers to an essay Sachin Jain and Christine Cassel published in JAMA (2010) that categorizes physicians as knights, knaves, or pawns. His take: “Knights are motivated by virtue…Knaves are selfish…Pawns are passive.” (p.7) Jauhar rides into medical practice as a knight in shining armor on a white horse after years and years of training. Would he be able to hang onto his knighthood?
As a young adult I believed that the world was accommodating, that it would indulge my ambitions. In middle age, reality overwhelms that faith. You see the constraints and corruption. Your desires give way to pragmatism. The conviction that anything is possible is essentially gone. (pp. 5-6)
Summary:The title of this book, “An American Sickness,” refers to the author’s view that the costs people who require health care must bear in the U.S. causes its own sickness. The author, Elisabeth Rosenthal, is a physician-turned-journalist so her use of a medical metaphor to explain the harms health care costs are causing people comes naturally to her. The sickness metaphor forms the structure for the entire book, and in particular the way a physician approaches a patient with a health problem to diagnose and treat. Thus, the introduction to the book is the “chief complaint,” Part I is the “history of present illness and review of systems,” and Part II is “diagnosis and treatment.”
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 Renewal of Generosity: Illness, Medicine, and How to Live contemplates the phenomenon of generosity as it is realized in the stories of physicians and patients. For Arthur Frank, generosity is grounded in the willingness of people to give themselves over to dialogical processes of communication wherein participants best realize themselves through relational engagement: generous, dialogical communication leads to a renewal and realization of human being. Health care systems today tend to impede communicative generosity, however, and the result is a de-humanization and de-moralization of both physicians and patients. As a remedy, Frank proposes, first, that we re-figure our conceptualization of the physician-patient relationship—from the economic or business metaphor of “provider” and “client,” we should turn to the metaphorical conceptualization of “host” and “guest,” which clearly has implications for manner of treatment and communication that occurs in the relationship. In addition, Frank turns to and thinks with stories of physicians and stories of the ill to reflect on the ways that generosity is realized. Drawing on the wisdom of the striking philosophical triumvirate of Marcus Aurelius (Stoicism), Mikhail Bakhtin (Dialogism), and Emmanuel Levinas to amplify the reflections emerging from the physician and patient stories, Frank ultimately proposes “exercises” for training to generate a vivifying generosity within the medical profession, which can in turn lead to a re-humanization and re-moralization for physicians, improved care for patients, and enhanced flourishing for all.
Summary:The Knick was inspired by the Knickerbocker Hospital, founded in Harlem in 1862 to serve the poor. In this 20-part TV series spread out over two seasons, the fictional Knick is somewhere in the lower half of Manhattan around 1900. The time covered during the series is not marked in any distinct way. The characters don’t age much, and although fashion and customs remain static during the series, the scope and significance of advancements that come into play were actually adopted over a longer time than the episodes cover.
Summary:This Petrarchan sonnet of 15 lines begins as a lyric contemplation of the Norwegian sea-beast of Scandinavian mythology; but it evolves into an association of the beast with other mythological representations of invisible yet vast, destructive forces that would devour from below or swallow sojourners on the seas of everyday life. In a broader sense, then, and by means of the mythological representation, the poem may be understood as a contemplation of ideology and blind allegiances to the status quo—which lose their destructive powers only when they are recognized for what they are.
Summary:The narrator of this story is a lifeguard who contemplates his identity and life-roles as he lounges in his lifeguard chair, elevated above the crowd of beachgoers. In the winter months, he is a student of divinity; in the summer months, he ascends the throne marked with a red cross in the hopes of guarding the lives of those at play before him. While he remains vigilant for calls of help, those calls never come, and the lifeguard confronts the troubling insight of the limited contributions he’s devoting his life to make.
Summary:On February 7, 1649 –one week after the execution by decapitation of Charles I, his royal physician, William Harvey (1578-1657), discoverer of the circulation of the blood, writes to his cousin, Edward Francis, a lawyer, once his friend but now firmly in the camp of Cromwell. Harvey muses on how his responsibilities as physician to the king must place him in the royalist camp. But as a doctor he will tend to anybody – Every Body—because all bodies are governed by the same natural laws. He wonders what his place will be in the new political order. And he wonders if his cousin noticed him when he stood by the king in battle – and if they will ever meet again in friendship.
Summary:The aim of these reflections on uncertainty in medicine is not to discredit evidence-based medicine or to incite suspicion of the careful and caring processes by which most clinicians arrive at the advice they give. Rather it is to change conversations among practitioners and between them and their patients in such a way as to raise everyone’s tolerance for the inevitable ambiguities and uncertainties we live with. If the public were more aware of the basic rules of mathematical probabilities, how statisticians understand the term “significance,” and of how much changes when one new variable is taken into account—when a new medication with multiple possible side-effects is added to the mix, for instance—they might, Hatch argues, be less inclined to insist on specific predictions. He goes on to suggest that there is something to be gained from the challenge of living without the solid ground of assurances. When we recognize the need to make decisions with incomplete information (a condition that seems, after all, to be our common lot) we may refocus on the moment we’re in and see its peculiar possibilities. Changing the conversation requires a critical look at medical education which, Hatch observes, “measures a certain type of knowledge essential to medical practice, but it consequently engenders a conception of medicine best described as overly certain . . . .”