Showing 121 - 130 of 477 annotations tagged with the keyword "Medical Ethics"
Subtitled "Tuberculosis and the Social Experience of Illness in American History," the book chronicles the medical and societal treatment of tuberculosis in the United States from the perspective of individuals who suffered from the disease. The author includes illness narratives derived from letters and diaries of the afflicted; her analysis spans the period in American history from the nineteenth through the first half of the twentieth century.
The book is divided into four sections. Part I, "The Invalid Experience: New England Men, 1810-60" and Part II, "The Female Invalid: The Narrative of Deborah Vinal Fiske, 1806-44" reveal an interesting contrast in the medical/societal treatment of tubercular men and women, and the resulting differences in their lives as "consumptives." Whereas men were expected to seek a cure by embarking on sea voyages and other travel, women remained at home and sought to control the disease by adjustments in domestic life. For men this meant major disruption and even change of career along with a sometimes exhilarating change of scene; for women it meant relentless anxiety and elaborate coping strategies.
Part III, "Health Seekers in the West, 1840-90" describes the role of cure-seekers in the westward migration and demonstrates how the culture of the time, an optimistic faith in nature and in the economic promise of the newly settled western territories, was reflected in the treatment regimen for tuberculosis. Interestingly, much of the promotional effort to bring "consumptives" west was initiated by physicians who were themselves tubercular.
The final section, "Becoming a Patient, 1882-1940," moves into the modern era with the discovery of the tubercle bacillus, public health measures, and the illness narratives of people who were confined in sanatoriums. Rothman points out that this period marked a transition away from the patient’s ability to understand and determine his/her treatment to one more like the current one in which the medical establishment is the authoritarian "expert."
A Doctor's Story of Friendship and Loss, this book is, in a sense, a sequel to Verghese's earlier memoir, My Own Country: A Doctor's Story of a Town and Its People in the Age of AIDS (see this database). The Tennis Partner tells the parallel stories of Verghese's disintegrating marriage as he establishes new roots in El Paso, Texas and of his new deep friendship with a (male) medical student who shares his passion for tennis. Both men are struggling to re-establish order in their personal lives: Verghese, in easing himself out of a dying marriage while trying to maintain a close relationship with his two sons; David (the tennis partner), in remaining drug-free and successfully completing medical training, which had been interrupted by his addiction.
Verghese, an experienced physician trained in infectious disease and an expert on AIDS treatment, relishes his role as David's mentor; David, a former tennis "pro," enjoys teaching Verghese how to play better. Playing tennis together for the sheer joy of it, each finds release. Tennis becomes the route through which each can unburden himself to the other, seeking solace in a difficult time. Through it "we found a third arena outside of the defined boundaries of hospital and tennis court . . . at a time in both our lives when friendship was an important way to reclaim that which had been lost." (339)
While the reader suspects that David must have a drug problem because the Prologue to the book, narrated in the third person, describes a "young doctor from El Paso" in drug treatment, Verghese the biographer has no inkling of the problem until one-third into his first person narrative. He is shocked, but in some ways the bonds of their friendship are strengthened. Each has only the other as a confidant.
David, however, has another addiction: women. The friendship becomes increasingly complicated as Verghese tries to remain both supportive and objective. Eventually David resumes "using" and Verghese must decide how to respond, both professionally and on a personal level. The turmoil in both lives ends tragically for David and causes profound grief in Verghese.
Summary:Spoiler alert: for educational purposes, this annotation reveals plot lines and may interfere with some viewers' enjoyment of the film. In the opening scene, Juliette (Kristin Scott Thomas), looking ashen, drawn, and nervous, sits in an airport as her much younger and radiant sister Léa (Elsa Zylberstein) rushes to meet her. Léa brings an eager, if somewhat forced cheer to their halting conversations during this meeting and in their car ride to the home Léa shares with her husband, their two small adopted Vietnamese daughters, and her mute father-in-law. From this awkward beginning, the sisters try to cross the chasm of a fifteen-year separation. The cause and nature of the separation gradually unfold in small, slowly paced scenes of ordinary life at home, at work, in a café, during dinners with friends. These scenes form the visible surface under which secrets and plangent, unacknowledged emotions lie, sometimes erupting into view, sometimes gently suggested.
This thought-provoking book is a collection of readings which the editors have found to be particularly useful for a course they teach, "What’s Normal?" It is their intent to facilitate consideration of how the world is experienced by those who are socially marginalized because of their physical appearance. The title of the anthology derives from an article written by the literary critic, Leslie Fiedler, and reproduced as the lead-off essay. Fiedler argues that the propensity of cultures throughout history to define the normal and to make political decisions about physical "abnormality" has reached a point where the rich will perpetuate the cult of normalcy (by paying for medical treatments that ensure it) while "the poor . . . will be our sole remaining Freaks."
The anthology is divided into several sections: Part I contains nonfiction articles, essays, and excerpts from books. Part II reproduces fiction, poetry, and drama and is further subdivided into "Abnormal Weight and Eating Disorders"; "Abnormal Height-Dwarfism"; and "Deformity and Disability." Many of the pieces have been annotated individually for this database (e.g. Fat by Raymond Carver, annotated by Carol Donley and also by Felice Aull and Irene Chen; Skanks by Rennie Sparks; The Fat Girl by Andre Dubus; Weight Bearing by Patricia Goedicke; Dwarf House by Ann Beattie; The Song the Dwarf Sings by Rainer Maria Rilke; The Dwarf by Ray Bradbury; The President by Donald Barthelme; The Birthmark by Nathaniel Hawthorne; The Elephant Man by Bernard Pomerance and others).
This anthology culls 1,500 excerpts from approximately 600 works of literature primarily written in the past two centuries and representing all major genres--the novel, drama, poetry, and essay. These brief selections highlight how literature portrays the medical profession and also provide ample evidence of many recurrent themes about the doctor-patient relationship and the personal lives of physicians present in the pages of fiction.
The book is organized into eleven chapters devoted to the following subjects: the doctor's fee, time, bedside manner, the medical history and physical examination, communication and truth, treatment, detachment, resentment of the medical profession, hospital rounds, social status, and the doctor in court. Many well-known authors including Anton P. Chekhov, Sir Arthur Conan Doyle, Ernest Hemingway, Thomas Mann, W. (William) Somerset Maugham, Leo Tolstoy, Tennessee Williams, and William Carlos Williams are featured in this anthology but less notable writers are also introduced. A twenty-three-page bibliography of primary and secondary sources is a useful element of the book.
Bomgard, a young doctor recently transferred from a rural area to a small town hospital, receives an urgent message from Polyakov, the doctor who replaced him. Polyakov has become ill; he needs medical help. Before Bomgard can respond, however, Polyakov arrives at the hospital, dying of a self-inflicted wound. In his last moments, he gives Bomgard a notebook, on which is recorded the story of Polyakov's addiction to morphine.
Polyakov first took morphine to relieve an abdominal pain. He found that it also relieved his despair over the loss of his lover, an opera singer in Moscow. Morphine relieved his loneliness and improved his work. He gradually increased the dose until he became hopelessly dependent on the substance. He failed in his attempts to break the habit at a clinic in Moscow. Eventually there is nothing in life but the drug and Polyakov suicides.
Dr. Thomas Graboys is an eminent Boston cardiologist who developed Parkinson's disease in his late 50s. Shortly after his wife died in 1998, Graboys noticed unusual fatigue and mental sluggishness. He attributed these symptoms to grief, but they continued and he later experienced episodes of stumbling, falling, and syncope. During 2003 Graboys confided to his diary that it was "increasingly difficult to express concepts." ( p. 30) He also noticed tremor, problems with dictation, and frequent loss of his train of thought, symptoms "typical of Parkinson's." (p. 24)
While Graboys recorded these concerns in his diary, outwardly he denied that anything was wrong, even to family and close friends. In fact, his denial continued until the day in 2003 when a neurologist friend accosted him in the parking lot and pointedly asked, "Tom, who is taking care of your Parkinson's?" (p. 27) Dr. Graboys faced an even more difficult challenge in 2004 when he developed the vivid, violent dreams and memory lapses that led to a diagnosis of Lewy body dementia, a form of progressive dementia sometimes associated with Parkinson's disease. With the cat out of the bag at last, the author finally began to confront the issue of professional impairment. In mid-2005 Graboys's colleagues seized the initiative and told him that "it was the unanimous opinion of my colleagues that I was no longer fit to practice medicine." (p. 36)
Writing now with the assistance of journalist Peter Zheutlin, Graboys reviews these events with unblinking honesty. He confronts his anger and denial, but also reveals the thoughtful, generous and passionate side of his character. "What will become of me?' This is the question that now lies at the center of Dr. Graboys' personal world. He knows that his loss of mental and physical control will worsen. With almost superhuman effort and his family's strong support, the author has been able to adapt to his limitations and maintain a sense of meaning in his life. Will that continue? In a chapter entitled "End Game," he addresses the question of suicide. Reflecting on his condition, especially the dementia, Graboys asks, "Will I lose myself, my very essence, to this disease?" (p. 161)
In the last chapter, Graboys acknowledges that he has no "simple prescription that will help you or someone you love live a life beyond illness, or tell you how to tap the hope that lives within." (p. 181) However, he then goes on to make several suggestions of the advice-manual variety: "Use your family and friends as motivation to live life with as much grace as you can muster." "Find a safe place... to unburden yourself of anger." "Acceptance is key to defusing anger, stress, and self-pity." "Use your faith in God, if you believe in God." (pp. 181-182)
This play was suggested by the book, Bad Blood: The Tuskegee Syphilis Experiment, by James H. Jones, and by a number of primary sources. It brings to the stage in a fictional way the story of the interaction between an African-American public health nurse assigned to the Tuskegee Syphilis Study and four of the African-American participants in the study. Two physicians, one who is head of the Tuskegee Memorial Hospital, and one from the U.S. Public Health Service, are less important characters, but provide the evidence of the government's complicity in the study.
The physical setting of the play is the Possom Hollow Schoolhouse, and there are changing "testimony areas" where a 1972 Senate subcommittee investigation of the Tuskegee study is taking place. The theatrical setting is, however, the conscience and memory of Eunice Evers, the nurse, as she is pulled into and out of the action to give testimony to the audience.
Act One takes place in 1932, and allows the audience to become acquainted with the four African-American men who, along with several hundred others, become part of the study after their blood has been found to test positive for syphilis. The treatment of the infected men with mercury and arsenic comes to an end after six months because of a lack of funds, and a decision is made by the Public Health Service to continue a study of untreated syphilis in these men. A fifty-dollar life insurance policy is given to each man as an inducement to remain in the study.
Act Two carries the lives of the characters through the introduction of Penicillin as treatment for syphilis in 1946--a treatment from which the Tuskegee study patients were excluded--and on to 1972, when the Senate committee hearings were held. The Epilogue is about the big guilts of the government and the little guilts experienced by Miss Evers as she questions her nursing ideals.
Summary:A son’s story of his father’s illness, treatment, and resultant destruction by the "psychic-driving" experiments of Dr. Ewen Cameron at Montreal’s Allan Memorial Institute in the 1950’s. The effect of the father’s illness on the family is recounted, as is the son’s gradual realization, only when he is himself about to become a psychiatrist, that something abnormal must have taken place during those long hospitalizations. Weinstein tells other patient stories in some detail as he recounts the legal fight for compensation awarded finally in October, 1988.
The aged, black nurse, Eunice Evers (Alfre Woodward), testifies before the 1973 Senate hearings into the Tuskegee study. Through a series of lengthy flashbacks, her testimony evokes the 1932 origin and four-decade course of a research experiment to study but not treat syphilis in the black men of Macon County, Alabama. The federally funded project began with the intent to treat the men, but when funds dried up, the project coordinators decided simply to document the course of the disease to discover if blacks responded to syphilis as did whites.
The nurse was deeply attached to the patients and they, to her; a Dixie band named itself "Miss Evers' Boys." Evers and her doctor supervisor (Joe Morton) hoped that treatment would be restored after a few months, but ten years pass. With the advent of penicillin in 1942, her intelligent lover Caleb (Laurence Fishburne) rebelled, took penicillin, and enlisted in the army; the project, however, continues.
Evers is disbelieving when she realizes that the men will not be treated, but she cannot abandon them. Against the advice of her father, she refuses to leave Alabama with Caleb and continues to participate in the lie that encourages the Tuskegee men to remain untreated into the late 1960s. One by one Miss Evers' Boys die or are disabled by the disease.