Showing 111 - 120 of 478 annotations tagged with the keyword "Art of Medicine"

Summary:

This book is exactly what it claims to be in the title. Dr. Ofri gives us fifteen clinical tales, each of which describes a lesson she has learned from a patient or from her own experience as a patient. It is an extension of her first book, Singular Intimacies: On Becoming a Doctor at Bellevue (see this database) and relates to her experiences after she completes residency training at Bellevue Hospital in New York City, to which she eventually returns as a staff physician. Three of the stories are examples of how a physician experiences the patient role, including one in which she relates an early personal experience to that of a patient she cares for ("Common Ground").

Since Ofri served as several locum-tenens, some of the stories take her to rural communities and small towns but most concern experiences with patients at Bellevue in clinics or in the hospital. She also discusses the challenges and limitations of teaching the next generation of doctors at Bellevue ("Terminal Thoughts").

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Summary:

This edited anthology, which includes poems, essays, short stories, and other creative forms (e.g., a radio diary, a letter to a social service agency), is organized into sections that include Body and Self, Diagnosis and Treatment, Womanhood, Family Life and Caregiving, Professional Life and Illness, and Advocacy. Most works found their way into this collection through a call for submissions, although a few selections are well known, such as Lynne Sharon Schwartz's "So You're Going to Have a New Body !," or an excerpt from Rachel Naomi Remen's Kitchen Table Wisdom (see annotations). In addition, the anthology also includes essays by scholars such as Arthur W. Frank and Rita Charon, who theorize gendered illness narratives.

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Annotated by:
Nixon, Lois LaCivita

Primary Category: Literature / Poetry — Secondary Category: Literature / Poetry

Genre: Poem

Summary:

The title recalls Clotho, the Fate charged with spinning the thread of life which would someday be clipped by her sister, Atropos. The two-stanza poem describes the circumstances of illness within a hospital setting. In stanza one, with a patient unable to urinate on his own, the poet employs desert images to suggest the dryness felt by the incapacitated sufferer ("throat-filling Gobi," "dry as Arabia," sunburnt cage of bone," "shekel," "rugs," "camel," etc.).

Stanza two begins with the riddle of the sphinx, another reiteration of desert imagery, but moves quickly to modern medical intervention by substituting the cane, the third leg of the elderly, with an IV pole for liquid sustenance and the "snake-handlers fist of catheters," ridding the body of its wastes. Clotho's role has been usurped by technology's miracles, and an appeal is made for the "kind, withdrawn face trained in the arts of love."

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A Deathplace

Sissman, L. E. (Louis Edward)

Last Updated: Feb-22-2010
Annotated by:
Nixon, Lois LaCivita

Primary Category: Literature / Poetry — Secondary Category: Literature / Poetry

Genre: Poem

Summary:

Sissman, whose chronic illness inspired him to incorporate illness experiences into his writings, muses about where he is likely to die. Like an archaeologist he begins with a vivid description of factors and events contributing to various wings and pavilions. He knows this hospital well: its external facades with "Aeolian embrasures" and "marble piping" associated with certain patrons or patronesses such as "the Maud Wiggin Building . . . commemorat[ing] a dog-jawed Boston bitch".

Slowly the narrator moves from the hospital's exterior layerings to imagine himself, a patient on a gurney, wearing the "skimpy chiton" while being subjected to syringes, "buttered catheter[s]," and IV "lisps and drips." Just before death his blood will "go thin, go white" and finally, there will be a journey through the hallways to the morgue and then to the undertaker. "That's all." The account is prosaic, an inventory or catalogue of steps familiar to anyone who has worked in a hospital setting. As a poet, however, Sissman transforms the ordinary into vividly fresh portrayals.

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Suburban Shaman

Helman, Cecil

Last Updated: Feb-22-2010
Annotated by:
Nixon, Lois LaCivita

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Because this lucid, rich, and incisive book has not, as yet, been published in the United States, it has not acquired the readership it deserves. For those teaching Medical Humanities or those interested in broader or more global stories and perspectives about physician training, practice, and experiences, Helman’s most recent publication should be considered.

Part One (“Setting Out”) begins in South Africa where Helman’s family, comprised of a dozen doctors, has lived for generations and where his own medical studies occurred. As a child, he accompanied his father on rounds while other children spent holidays at the beach. Before long he discovered how hospitals, during the madness of Apartheid, were to “some extent a distorted mirror-image of the world outside” (3). Appalled by the differences in care and treatment, the keenly aware young man kept notes. His vivid observations of the harsh context of social injustices provide an unequivocal, eloquent, and disturbing critique of medicine then and there. His acute observations of physician behaviors and indigent populations in the city and in the bush contribute, as readers discover in later chapters, to the author’s expanded and compelling interests in cultural anthropology.

Part Two (“The Family Doctor”) leads to London. “After all the heat and light and space of Africa, London—with its low leaden sky and constant drizzle—was like living inside a Tupperware box, one stored deep inside a refrigerator” (47). In the 60s Helman’s migration required an adjustment to a world of technology and order, where as a family practitioner, he had become, in fact, a suburban shaman. In any society, patients wanted “relief from discomfort, relief from anxiety, a relationship of compassion and care, some explanation of what has gone wrong, and why, and a sense of order or meaning imposed on the apparent chaos of their personal suffering to help them make sense of it and to cope with it” (xvi).

Gradually Helman saw connections between the role of family physician and traditional healer: both involved an understanding of “not only a body’s internal equilibrium but also the equilibrium of the patient’s relationships with the world he or she lives in and how treatment should aim not only to treat the diseased organ but also to restore the patient’s life that equilibrium of relationships” (xvii). His encounters with patients and the stories they reveal suggest how important these often overlooked connections are and why they ought to be included in medical training and practice.

By the time readers reach Part Three ("States of the Art”), the author has moved into broader realms of thinking, in which medicine and illnesses are examined anthropologically. After 27 years of clinical practice Helman’s white coat and stethoscope are placed on a hook. Now, as a credentialed anthropologist at University College London, his larger lens allows for sustained scrutiny of the complexities, ambiguities, and nuances in such chapters as “Grand Rounds,” “Hospitals,” “Placebos,” “Third Worlds.” Helman’s range of experiences, multi-disciplinary training, intellectual conclusions, and abundant common sense argues for techno-doctors to learn from holistic practitioners. Whether devastating or humorous, the critiques reflect not just care provision but shared human capacities: the insights are thoughtful and fresh and very worthwhile.

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Leaning Together in the Storm

Smith, Larry

Last Updated: Feb-22-2010
Annotated by:
Nixon, Lois LaCivita

Primary Category: Literature / Poetry

Genre: Poem

Summary:

Summary: This very welcome poem concerns "twelve older men in shirt sleeves," a group of men with prostate cancer. The narrator, one of the men in this "private brotherhood" suggests the difficulty and reluctance of many men to recognize out-loud their mutual circumstances: "Ever notice how no one parks / in the Cancer Center zone." This line sets the tone; the men are vulnerable and afraid. From time to time they gather for support from one another and from the meeting's scheduled speaker. The reader has little difficulty imagining the collective angst and the grasping of hope shared by the participants leaning together in their mutual storm.

Any expectation of supportive discourse is shattered by this evening's guest speaker, a careless surgeon, who strides confidently into the room with his tray of slides. The remainder of the poem demonstrates a worst-case scenario:

I interrupt his gay delivery,
"What about orgasm...?"
"Forget orgasm," he grins,
"You don't have a prostate."

Some smile nervously and bravely ask questions that really matter. Each time the physician exhibits his caustic brand of insensitivity. The narrator, surely expressing the feelings of his colleagues, wants only to "drive / this witch doctor from the room."

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The Gift Nobody Wants

Brand, Paul

Last Updated: Feb-12-2010
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Nonfiction

Genre: Autobiography

Summary:

Dr. Paul Brand, who grew up son of English missionaries to South India, achieved world renown for his research on leprosy and related research on the dynamics of pain. This book, one of several of his reflections on physiology, combines autobiography, stories of research, and reflections on pain and pain management. The three topics roughly correspond to three discrete sections.

It opens with a story of the early death of a child with a rare neurological dysfunction that made her insensitive to pain. Brand's long work with victims of leprosy in India and then in Carville, Louisiana, gave him wide exposure to the consequences of life without adequate pain. Having spent 27 years in India, 25 years in England, and 27 years in the U.S. before writing this retrospective, many of his reflections include observations about cultural variables in perception of pain, how pain is communicated and managed, and how people deal philosophically with the problem of pain.

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Somatic Fictions

Vrettos, Athena

Last Updated: Feb-11-2010
Annotated by:
Holmes, Martha Stoddard

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

This scholarly study examines "what it meant to ’talk of diseases’ in the second half of the nineteenth century" (2) and how discourses of health and illness were a vehicle for exploring individual and social identities, including gendered, racialized, and national identities. Narratives of physical illness are not simply artifacts of Victorian medical culture, Vrettos argues, but offer examples of the pervasive "master narratives" that shaped Victorian middle-class culture.

Individual chapters focus on the ill female body as an expressive text with variable legibility (and on nurses as privileged readers of ill bodies); "nervous illness" and the role of narrative in reconstructing the self; "neuromimesis" or neurotic imitation of disease; and the "politics of fitness and its relation to imperialist ideology." Vrettos discusses fictional works by Louisa May Alcott, (Hospital Sketches; see this database) Charlotte Bronte, George Eliot (Middlemarch; see this database), H. Rider Haggard, Henry James, Bram Stoker, and Harriet Beecher Stowe.

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Metamorphosis

Updike, John

Last Updated: Feb-11-2010
Annotated by:
Holmes, Martha Stoddard

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The protagonist, Anderson, has a skin cancer growing dangerously close to one of his tear ducts. An aging "idler and playboy," he has spent too many years in the sun (67). Anderson consults and promptly becomes infatuated with his facial plastic surgeon, Dr. Kim, "who turned out to be a woman, a surprisingly young Korean-American who even in her baggy lab coat evinced considerable loveliness" (67). Anderson is fascinated with Dr. Kim's body, her visible pregnancy, her way of moving and speaking, and her face. He enjoys the "bliss of secure helplessness" of the surgery itself, performed by Dr. Kim and two female nurses who "rotate[]" around him conversing as they work (67).

While successful, the surgery leaves a small bump on his face that Anderson asks Dr. Kim to correct surgically. The second surgery achieved, Anderson returns a third time for the much more ambitious project of tucking his somewhat saggy eyelids. His goal, however, is not just to tighten slack skin but to make his lids look like Dr. Kim's, "with an epicanthus" (69). The six-hour surgery is both successful and satisfying to Anderson--until he sees a photo of Dr. Kim's husband.

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A Stone Woman

Byatt, A. S. (Antonia Susan)

Last Updated: Feb-11-2010
Annotated by:
Holmes, Martha Stoddard

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The story opens with the death of the protagonist’s beloved mother, with whom she lives. Ines, a dictionary researcher, is soon jolted from her grief by the excruciating pain of a “twisted and gangrenous gut” (112). After a hospital stay and emergency surgery, she returns home to recuperate from the physical trauma and revisit her mourning. On the day when she can remove the wound dressings, Ines discovers a surprising change in her body: it seems to be turning to stone. Her incision has become a “raised shape, like a starfish, like the whirling arms of a nebula in the heavens” that gradually spreads to the rest of her body, forming "ruddy veins" across her belly and "greenish-white crystals sprouting in her armpits" (119).

Ines assumes that this process is fatal and that she will "observe [death's] approach in a new fantastic form" (121). Deciding to write a record for those who will find her after her demise, she studies the names and nature of minerals in order to understand and describe her metamorphosis. From her new, mineralizing perspective, she realizes that stones can be dynamic and living as well as fixed and dead; minerals are memorials to the relationships and reciprocities between living creatures and dead ones.

Unable to write the record of her transformation, Ines finds herself passionate to be outdoors. She explores the city, looking for "a place to stand in the weather before she became immobile" (127). In an old graveyard, she meets and gradually forms a bond with Thorsteinn, an old Icelandic stonecutter who may also be mourning the death (apparently of a child). The Ines shares the secret of her metamorphosis with the stonecutter and eventually travels with him to his homeland, a geologically young country, where stones are alive and myths tell of “striding stone women.” Thorsteinn sketches here in this landscape and creates a standing stone image of Ines that reflects his ability to see her as she is and find her beautiful: "Petra faction saw that she existed, in there" (150).

Ines's metamorphosis culminates in her inability to see or speak as a human and her ability to perceive a whole new realm of living creatures, "earth bubbles and earth monsters" (151) and other stone people who are "flinging their great arms wide in invitation" (156). She joins their wild dance.

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