Showing 121 - 130 of 237 annotations tagged with the keyword "Nursing"
Professor Sandra Bertman founded the Medical Humanities Program at the University of Massachusetts Medical Center and holds certificates in grief counseling and death education. This handbook outlines how she uses the visual and literary arts to "improve our professional abilities to deal with death and dying." Her premise is that the arts provide a valuable vehicle for exploring and making bearable the prospect and fact of death.
Bertman illustrates her presentation technique (Chapter 2) of juxtaposing dual images around six central themes, here abbreviated: the chosen death; death and afterlife; existential aloneness; loss of control, unmentionable feelings, grief; the land of the sick vs. the land of the well; the moment of death. The book offers dozens of paintings, sketches, and photographs (reproduced in black and white), as well as many literary excerpts. Classic works are represented (David's painting, The Death of Socrates; Michelangelo's sculpture, "Pieta"; Tolstoy's novel, The Death of Ivan Ilyich) but there are many unusual representations as well--greeting card messages, epitaphs, cartoons.
In addition, some groups with whom she works (for example, medical students studying Gross Anatomy) have submitted their own drawings and commentary. These are shown in Chapter 3, along with written responses to a follow-up Death Attitude Questionnaire. Responses are from junior and senior high school students; college students; medical students; graduate nurses; hospice volunteers.
Chapter 4 gives suggestions for how to use images and texts and for how to approach discussions of loss and grief. The course syllabus for "Dissection, Dying, and Death," taught with Gross Anatomy, is appended, and there is an extensive bibliography.
As Bertman says in her introduction, this book "is meant to refuel therapists, counselors, social workers, physicians, nurses, clergy and all others who are committed to providing support to those in grief." While the caregivers' focus is on those in grief, they also have to give some attention to their own bodies, minds and spirits. This collection of essays, poems and stories, illustrated with drawings and photographs, examines grief from several perspectives.
The opening section looks at professional roles in experiencing and understanding suffering and empathy. Section two provides several descriptions of how caregivers use the arts for themselves and for those they companion. Section three is devoted to lessons from old and new cultures. The final section explores basic needs of grieving people.
The surgeon-narrator and his team of assistants (the anesthesiologist, scrub nurse, circulating nurse, surgical resident, and medical student) perform a difficult operation during the night. The patient has an infiltrating cancer of the stomach (linitis plastica) that has eroded his aorta. Because of uncontrollable bleeding, the operation (an exploratory laparotomy with attempted repair of a malignant aorto-gastric fistula) is as doomed as the patient himself.
The surgeon soon comprehends the hopelessness of the procedure as well as the patient's terminal condition. He turns off the oxygen from the gas tank and stops the patient's blood transfusion. Minutes later, the man dies. Blood is all over everything. The doctor must now deliver the bad news to the man's family. He has the medical student tag along.
Members of the patient's family are upset and some are even out of control so he dispenses tranquilizers to them. The surgeon returns to the operating room (OR) and even now finds blood everywhere. The OR team is still working. The doctor showers and then goes back to the OR once more. The room is now dark and empty but clean. The surgeon imagines the dead man's body with a row of abdominal stitches that he likens to hieroglyphics. The unsuccessful operation and the surgeon's actions are thus both concealed and unforgettable.
The author of this bold collection is a registered nurse who relates, through her poems, patient and caregiver experiences culled from her own years of working in Intensive Care-Coronary Care. There are 24 poems here, most running two to three pages and most written in short lines, a point of craft that adds to their power. There is not one moment of easy sentimentality in these poems. Instead, the author plunges into the grittier side of nursing and illness--and yet, in aggregate, these poems celebrate the embodied and holy work of healing.
In the opening poem, "The-Trickle-Down-Theory-Of-Health," Adam, in the Garden of Eden, is surprised by "The knife" that "separates his ribs." By poem's end, we see health slip "like a ring / from earth's finger" (2), and with this simile we are introduced to the book's underlying metaphor and also to the poet's technique: dense and sometimes near-extreme imagery that ranges, in this poem alone, from encyclopedias to acid rain to barefoot children to librarians to a patient in the dark, "her arteries and shelves / of bone in a ruby gloom" (2). This accumulation of unrelenting, unusual images recreates the world of a patient's pain and suffering and the fierce determination and occasional despair of a caregiver.
"Coma" is written from a comatose woman's point of view, and yet we also see her from the nurse's vantage. In a lovely and surprising twist, the coma becomes, for the patient, a sort of liberation as "Slowly she sloughs, / cell by cell, / the old thorn" (15). This patient is not Sleeping Beauty, who in some fairy tale might be wakened by a kiss. "On the Fireline" becomes a wonderful metaphor for the daily confrontation of illness, for the way the nurse, returning daily to tend her patients, also "coalesces into fire" (16).
The 5-page poem "Intensive Care" perfectly renders the physical sense of being alternately caregiver, patient, and family member within the rarified atmosphere of the ICU (24-28). A patient's blood "pulls against/ the moon, his breath / this tide going out" (26) and, as she comforts a waiting family member, a nurse's eyes "beyond clarity, / unfold a silken language / all their own" (28).
Other not-to-be-missed poems are "The Holy O" (36), "Prayer to a Purple God" (38), "Pieta" (44), "A Riot of Flowers" (52), "What the Body Remembers" (57), and one of my very favorites, "Anesthesia" (59). In "Anesthesia" the caregiver lets an anesthetized patient float like "an embryo / tethered on the end of IV tubing, / floated like an astronaut / in cold stratosphere, / a naked thing / alone / in the universe" (60). But since these poems are finally loving, involved, experienced and hopeful, the patient is told to hush; he is watched over; he is protected. When danger is past, he is reclaimed: "She will hold you / within white-curved wings. / She will reel you back in / when you are healed" (60).
In the Foreword to this collection, poet John Graham-Pole writes, "Children have uncovered for me the last and greatest lesson: souls thriving on failing at bigger and bigger things" (xvii). The heroes of these poems are just such children, transformed by serious illness. For example, Dominic in "Waiting" who "rests on his airbubble cot / awaiting life’s flight from its earthly beat" (10); Ruby in "Ruby Red": "And so poor Ruby meets her final test, in gentle hemolysis rolled to res" (35); the lovely young woman in "Elegy": "You’re newly dead, sans wig, / seventeen year old virgin whom / I’d loved." (57).
"I try through writing poems to lay a finger on the purpose of illness, on its pulse . . Poems turn denial and withdrawal into compassion--feeling with. They turn fear into mercy--thank you" (xvii). The poet’s eye remains dispassionate, even though his heart may be breaking, as in "Last Rites" (32), in which a dead toddler’s father and his companion "sluice down the flooring with their hoses. After the vomit and blood the water runs clear." He understands the limits of communication about loss, but recognizes, too, that we must make the attempt; and the attempt has meaning in itself: "Afterward the circles of our talk / snap . . . - Within, we write our / separate texts of it. Between, the tension / stands: this no talk could break." ("Circles," p. 87)
Selzer tells four stories of surgical loss: a surprise loss on the operating table, the drowning of a sick child in a flood in wartime Korea, the sudden death of a professor due to a perforated ulcer, and the loss of some facial mobility in a young woman following the removal of a tumor in her cheek. As we move from one vignette to the next, the narrator's mood goes from despair to accepting to redeemed, with various forms of love the agent.
Set in 1894 and based on a history of the logging projects among the California sequoias, this is a story of Francie, whose sister died in an accident six years earlier. She chafes under her parents' excessive protectiveness since Carrie's death. She loves the woods, and longs to do something to keep the loggers from cutting down the ancient sequoias, especially the oldest and largest, a tree over 2500 years old. Through a little sleuthing based on her sister's diary, she finds out that the property on which the ancient tree sits actually belongs to an old hermit, not to the logging company.
In an effort to get the company to stop before cutting the oldest tree, she rides the dangerous log flume into town to alert the one journalist she knows will support her cause. They arrive in time to save that tree and some of the others, and, perhaps as importantly to Francie, her mother and father begin to see her not only in terms of their loss of Carrie, but as a young woman independently interesting, daring, and very much alive.
Fifteen selections--short stories, essays, and memoir--make up this collection. Two stories are notable: The Whistlers' Room and Atrium: October 2001 (see annotations). The title story is a translation and retelling of an obscure German tale published 75 years ago. Set in a military hospital in Germany during World War I, four soldiers share a common wound--throat injuries and laryngeal damage necessitating a tracheostomy for each man. This remarkable quartet of patients forges a fellowship of the maimed.
"Atrium: October 2001" describes the random meeting between a physician and a terminally ill teenager in the hospital atrium. The subject of death dominates their discussion. "Parable" chronicles an elderly doctor's efforts to comfort a dying man, and in the process, ease both their suffering.
Excerpts from Selzer's diary reveal much about the character of the author as well as the characters in his life. He also reminisces about growing up in Troy, New York. Approximately one-quarter of the book is devoted to Selzer's musings on works of art (sculpture and painting). Lighter fare includes a discussion of life behind the podium, a description of his home, and a new ending for A Tale of Two Cities by Charles Dickens.
Birth Sounds includes 45 short tales of labor and delivery, ranging through a wide swath of the human comedy, but always maintaining focus on the very first scene. In most of these stories, it isn't the delivery that provides the drama, but rather the people. Take the first story, for example. In "Faceless" a Vietnamese husband cautions the obstetrician-narrator, "In our country no man will examine a woman in such an intimate way." The obstetrician never sees the patient's face, which she has covered with a towel. After the delivery, he examines her and speaks carefully, not sure that she understands English. However, from beneath the towel, she thanks him in a perfect American Southern accent. A neat surprise!
In "The Little Devil" (p. 6) a 38-year-old member of a satanic cult announces that she intends to kill the baby if it is a boy. She has been directed to do so by her satanic mentor. When, amid a panoply of lit candles and inverted crucifixes she delivers a boy, the resident contacts the sheriff's office, where the mother's intentions are already known. Sure enough, the SWAT team storms the delivery room and takes the baby.
In "Red Bag" (p. 31) the narrator is serving as a medical expert in a murder trial. The defendant had arrived at the hospital hemorrhaging after delivering a baby at home, evidently into the toilet bowl. The baby had died of head injury. The obstetrician-narrator turns out to be more supportive of the woman and less compliant than the prosecutor had expected; but afterward the doctor receives his financial reward--a check from the state for a full $7.00!
In "Resilience" (p. 259) a woman with a near-term pregnancy asks the obstetrician to examine her breast, which has suddenly developed a red lump. He takes one look and immediately experiences a flashback to another young woman he cared for who had developed breast cancer during pregnancy and died of metastatic disease about a year later. Sure enough, the current patient also has cancer. But in this case the patient delivers, receives treatment, and recovers, apparently cured of her cancer.
Before and after an appendectomy (done for what seem possibly questionable indications) an adolescent boy just feeling the surges of pubescence receives the appropriate attentions of a nurse. During a follow-up visit, for no clear medical reason that I can fathom, he also experiences the exhilarating good luck, for him, of a sperm test, performed by the physician's "young, good-looking nurse."