Showing 131 - 140 of 558 annotations tagged with the keyword "Physician Experience"

The Oath

Baiev, Khassan

Last Updated: Nov-15-2009
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Baiev’s chronicle of medical life in wartime is full of incident—tragic, touching, and repeatedly traumatic:  his own life was threatened repeatedly by Russians who suspected him and Chechens who resented him for treating Russians.  Members of his extended family were killed and his father’s home was destroyed.  He straddled other boundaries:  trained in Russia, he fully appreciated how modern medicine may bring relief not available even in the hands of the most respected traditional healers, but he mentions traditional ways with the reverence of a good son of devout Muslims.  His perspective is both thoughtfully nationalistic and international.

Finally coming to the States where he couldn’t at first practice the medicine he had honed to exceptional versatility under fire, he lives with a mix of gratitude for the privilege of safety and a longing for the people he served, whose suffering was his daily work for years that might for most of us have seemed nearly unlivable.  Before writing the book, he struggled with his own post-traumatic stress, and continues to testify to the futility of force as a way of settling disputes.  Medicine is his diplomacy as well as his gift to his own people, and the Hippocratic Oath a commitment that sustained him in the midst of ethical complexities unlike any one would be likely to face in peacetime practice.

 

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Annotated by:
Shafer, Audrey

Primary Category: Visual Arts / Painting/Drawing

Genre: Art with Commentary

Summary:

One Breath Apart: Facing Dissection is a pictorial and narrative account of gross anatomy class in medical school. The book highlights the educational, moral and metaphysical opportunities anatomy courses afford those who dissect and learn from the cadaver. Educator and thanatologist Sandra Bertman has expanded on her work with medical students previously summarized in her book Facing Death: Images, Insights, and Interventions (see annotation).

Written with the first year medical student in mind, One Breath Apart is a compilation of drawings and writings by students from the University of Massachusetts Medical School between 1989 and 2002 in response to course assignments. The book is dedicated to the professor of the anatomy course, Sandy Marks - of note, the medical humanities module, including assignments and events were integrated into the course. Bertman describes the course and provides a plethora of student work.

Additionally, the book is enhanced by photographs by Meryl Levin, with writings by Cornell-Weill medical students, excerpted from Levin's marvelous study,  Anatomy of Anatomy in Images and Words. Also included is a foreword by Jack Coulehan, who writes of his experience with his cadaver ("We named him ‘Ernest,' so we could impress our parents by telling them how we were working in dead earnest." p. 7) and the lifelong impact of dissection on the student.

Of particular note is the variety of content included in this intriguing volume. Artistry is not a medical school admissions criterion, yet a number of the drawings have design components which are thought-provoking and profound. For example, on page 80 a female doctor adorned with white coat, stethoscope and bag stands beside an upright skeleton. They are holding hands.

Bertman concludes the book with photographs, drawings and text related to the annual spring memorial service for the body donors. The section includes eulogies by students and responses by donor family members. Writes medical student Nancy Keene: "Studying his body provided an opportunity which enhanced my education. But it was the giving of his body, which has remained with me as a lasting memory." (p. 87)

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Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

Suzanne Poirier has studied over 40 book-length memoirs describing medical training in the United States. These texts vary in format from published books to internet blogs, in time (ranging from 1965 to 2005), and in immediacy, some reporting during medical school or residency while others were written later--sometimes many years later.

A literary scholar and cultural critic, Poirier analyzes these texts thematically and stylistically, finding pervasive and regrettable (even tragic) weaknesses in medical education. Her three major points are these: such training (1) ignores the embodiment of future doctors, (2) is insensitive to the power relationships that oppress them, and (3) makes it difficult to create a nurturing relationship--especially by tacitly promoting the image of the lone, heroic physician.

While some of these repressive features have improved in the last decade or so--in contrast to the momentous scientific progress--there is a general failure to deal with the emotional needs of persons in training as they confront difficult patients, brutal work schedules, and mortality, both in others and in themselves.

In her conclusion, Poirier describes some contemporary efforts to help medical students write about their feelings, but she also sees the negative consequences of "an educational environrment that is inherently hostile to such exercises" (169).  Her challenge is this: " "Emotional honesty is a project for all health professionals, administrators, and professional leaders" (170).

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Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Late in the twentieth century, the young doctor Goodheart fails in a city practice and accepts a salaried position in the country.  Even there his difficulties persist. A challenging patient—the Reverend Pastor--refuses a tiny muscle biopsy that would not only confirm the diagnosis of trichinosis, but establish the doctor’s reputation. “I would rather die than let myself be skewered alive!” the pastor shouts (p. 11).

Deeply discouraged Goodheart wanders into the country at twilight, sighing, “If only there were a means of making the human body as transparent as jelly fish” (p. 13). Suddenly a woman appears in a blaze of light. She is “Electra the spirit of the twentieth century” (p. 15). She gives the astonished doctor a box and bids him open the lid. The nearby tree immediately becomes “as transparent as a jelly fish” (p.17). Next the box, judiciously aimed, illuminates the inner workings of a frog.

Goodheart applies his box to the ailing pastor and sees parasites teaming throughout his body. Then he effects a dramatic cure with helminthotoxin made from the worms themselves—a treatment that had been invented sometime during the century.

The box proves to be a simple electrical device, easily replicated. Declining financial recognition, to the vexation of his wife, Goodheart communicates the workings of the box to the world with no mention of Electra. But fame and riches flow his way and he dies in old age an honored man.

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Annotated by:
Woodcock, John

Primary Category: Literature / Fiction — Secondary Category: Literature / Fiction

Genre: Short Story

Summary:

In the time of house calls, the doctor-narrator is summoned to care for an ailing newborn. He discovers hospital-caused diarrhea and a severe congenital heart problem that can't be fixed. He also discovers the baby's fifteen-year-old sister, who has a bad case of acne and a direct, no-nonsense style that he finds very attractive.

The narrator's colleagues ridicule his interest in a family consisting of alcoholic and deceptive parents and a daughter who is not only chronically truant but notoriously promiscuous sexually. (To the narrator's enthusiasm about the young girl, his wife responds, "What! another?") In spite of these warnings, the narrator returns several times, probably without compensation, to check on the baby's diarrhea and feeding and to help the girl with her complexion.

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A Face of Stone

Williams, William Carlos

Last Updated: Jul-08-2009
Annotated by:
Woodcock, John

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The overworked doctor-narrator finds himself extremely irritated by the requests of a poor immigrant couple in their twenties to examine their infant. He spouts an alarming number of cultural and economic prejudices and tries to avoid seeing them. They persist, however, and the doctor examines the child, whom he finds healthy. The husband then asks if the doctor can examine his wife. The doctor flashes his anger again but agrees.

He finds her legs extremely bowed, probably from severe childhood rickets, and asks the husband about her history. It turns out that she had grown up in Poland during World War I and had lost all her family. As he hears of the woman's suffering, the doctor becomes empathetic, suddenly understanding the couples' fearful tenacity which had so annoyed him before. The woman responds in kind, and the doctor-patient relationship changes significantly for the better.

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Summary:

Born in 1921 in Belarus (White Russia), the author lost his father (a doctor) as a baby and was raised by his mother who worked as a surgical nurse and midwife. He excelled in school and was on the verge of entering medical school, but the political upheaval of World War II drew him away from studies.
 
Drafted to serve in the Polish army, the eighteen year-old became a sergeant in charge of a platoon by June 1939 fighting against Germany along its border with Poland. Three months later he was captured and imprisoned in cruel conditions. By November, he escaped and began a long walk home, helped by strangers, only to find that the Soviets had taken over. Arrested again, this time for being anti-Communist, he spent January to June 1941 in a Soviet prison, and narrowly avoided execution when the Russians retreated at the German invasion of Minsk. Another return home was met with the tragic news that his mother had been killed when German bombs hit the hospital in which she worked.

Enraged by the succession of destructive invaders, Ragula helped create a nationalist freedom army, the Eskradon, ironically with German support, and a Bulletin to inform citizens and lobby for better conditions. By the time World War II drew to an end he was married to Ludmila (in 1944) and on the move, seeking a medical education.

As refugees, the couple moved to Marburg, Germany in 1945, where Ragula began medical school. But money was always a problem and the post-war restructuring of Europe made them fearful. Hearing of a program for refugees in Louvain, Boris entered Belgium illegally in 1949 and finally completed his medical degree in 1951 at age thirty-one. In 1954, the couple settled in the medium-sized town of London Ontario, Canada. There Ragula interned and set up a family practice. He and Ludmila raised their family of four in peaceful security that contrasted starkly with their own upbringing.

Precocious in promoting health, Ragula campaigned tirelessly against smoking, inactivity, and overeating, and he worked in aboriginal communities, convinced that a doctor's role was to prevent disease as much as it was to treat it.  Here too he found enemies and friends.
 
In 1963, Ragula was involved in a non-related kidney donation between patients-a selfless act that touched him deeply. For him, it represented the pinnacle of scientific achievement and epitomized how humans should care for one another.

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Summary:

This collection of stories offers a sidelong view of medicine from the perspective of a thoughtful, experienced doctor of internal medicine at a teaching institution (UCSF) in an urban setting that brings a wide variety of types of patients to his door.  In a context of evident respect and admiration for even the quirkiest of them, Watts admits to the kinds of personal responses most have been trained to hide-laughter, anger, bewilderment, frustration, empathetic sorrow.  The cases he recounts include several whose inexplicabilities ultimately require action based as much on intuition as on science.  He includes several stories of illness among his own family and friends, and makes it clear in others how his professional decisions affect his home life and his own state of mind.  

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Cutting for Stone

Verghese, Abraham

Last Updated: Mar-08-2009
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Ethiopia, 1954. Twin boys conjoined at the head survive a surgical separation and a gruesome C-section delivery. Their mother, Sister Mary Joseph Praise, does not. The Carmelite nun, a native of India, dies in the same place where she worked as a nurse - the operating room of a small hospital in Addis Ababa. The facility is dubbed Missing Hospital, and it is staffed by some remarkable people.

Thomas Stone is a British general surgeon. The only thing that he loves more than medicine is Sister Praise. When she dies during childbirth, he has a meltdown - abruptly fleeing the hospital and leaving Africa. Although Thomas Stone is the father of the twins, he blames the babies for the nun's death. Decades later, he is working at a prestigious medical center in Boston where he specializes in hepatic surgery and research on liver transplantation. The twins are raised by two physicians at Missing Hospital - Dr. Ghosh and Dr. Hemlatha (Hema) - who get married. Hema is an obstetrician-gynecologist. Ghosh is an internist who becomes the hospital's surgeon by necessity after Thomas Stone departs.

The fate of the twin boys, Marion Stone and Shiva Stone, is sculpted by their experiences at Missing Hospital and the growing pains of Ethiopia. The African nation is full of possibilities and mayhem. Both boys are highly intelligent and unusually bonded. Shiva is eccentric and empathic. Although he never attends medical school, Ghosh and Hema train him. Shiva becomes a world authority on treating vaginal fistulas. Marion narrates the story. He is repeatedly hurt by love. The girl of his dreams, Genet, opts to have her first sexual encounter with Shiva. Genet plays a role in hijacking an airplane and rebels against the Ethiopian government. Although innocent, Marion comes under suspicion because of her actions. He escapes the country for his own safety.

Like his father, Marion lands in America. He completes his residency training as a trauma surgeon in New York. He locates his biological father but reconciliation is difficult for both men. Genet has also come to America. She shows up at Marion's apartment, and they have sexual intercourse. Genet exposes him to tuberculosis and Hepatitis B. Marion delevelops liver failure due to hepatitis. He is going to die. Shiva and Hema travel to New York to be with Marion. Shiva proposes an experimental treatment for his brother - a living donor liver transplantation. After all, there is no better organ donor than an identical twin. Thomas Stone performs the operation along with one of Marion's coleagues. The surgery is successful. Then Shiva has bleeding in his brain and dies. Marion returns to Ethiopia and Missing Hospital. Half a century removed from his birth, Marion is back at home and still conected to his twin brother. The lobe of liver donated by Shiva is functioning perfectly.

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Summary:

This survey of the history of women in medicine begins in the mid 19th century and moves forward to the late 20th Century.  The twelve historical studies are divided by the editors into three sections, largely chronological.  The first section focuses on the 19th century women best known for their breakthrough into the male bastion of regular medicine in America.  There is, in addition to the more traditional studies, a look at the role of a Chinese woman physician in Progressive Era Chicago.  Section two takes the reader into the early 20th century Womens' Health Movement, including a fresh look at the narrative forms of Our Bodies, Ourselves.  Section three examines the mid-late 20th century position of women in American medicine and an interesting discourse on the impact of Western women physicians on issues of childbearing in Asia during the early part of the same century.

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