Showing 131 - 140 of 203 annotations tagged with the keyword "Psycho-social Medicine"

Summary:

The description on the cover of this collection of essays states that it is "candid firsthand accounts of the profound experiences that transform medical students into doctors". It is edited by a woman breast surgeon (Susan Pories) who teaches students in the Harvard Medical School Patient-Doctor Course; a MD/MBA candidate (Sachin Jain) who anticipates a career as a clinician , scholar and activist; and a psychiatrist (Gordon Harper) who is director of the Patient-Doctor III course at Harvard. The short forward is by physician-writer Jerome Groopman. The 44 essays are divided into sections by theme: Communication, Empathy, Easing Suffering and Loss, and Finding a Better Way. I found it helpful to read the short biographies of each student in the back of the book, before reading that student's essay.

The diversity of the essayists is very wide which makes for a broad look at many important issues. There are several subjects that we tend to avoid (student response to the nude body, the presence of students when end of life decisions are being made, the tensions between caring for a patient and having to do something which causes pain, trying to think of patients a people as well as complex biomedical problems). One of the editors wishes that the book will help people understand the working of the hospital and the many ways in which new doctors learn. The book is certainly a personal look at the teaching hospital from the students' view.

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Of Mist, and Grass, and Sand

McIntyre, Vonda

Last Updated: Sep-05-2006
Annotated by:
Kohn, Martin

Primary Category: Literature / Fiction

Genre: Novelette

Summary:

Although the setting is startlingly different, and the care provided is through highly unorthodox means, the healer in this science fiction story experiences in remarkably similar ways the everyday wear and tear of modern medical practice. Snake, a young female itinerant healer, has been asked to save the life of a young boy. Her attempts to do so, and her interactions with the boy, his family and community, and the tools of her trade (the snakes-mist, sand and grass) are detailed in the story. "Professional development" issues that this strong and complex character has to deal with include truth-telling, interfering and ignorant family members, self-sacrifice, and possible reprobation by her peers and teachers.

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Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Nonfiction

Genre: Autobiography

Summary:

In 1996, at the age of 31, David Biro is preparing for his specialty examinations in dermatology and is set to share a practice with his father. But he develops a visual disturbance. After repeated testing, he is found to have the rare blood disorder of paroxysmal nocturnal hemoglobinuria. The diagnosis was problematic, but the treatment choices are overwhelming. His youngest sister is a suitable donor, and he opts for a bone marrow transplant. He realizes that his decision was influenced not only by the diagnosis, but also by his personality and his reaction to the physicians.

Advance preparations are hectic and sometimes comic, especially his deposits at a local sperm bank. The pain of the transplant and the six weeks imprisonment in a small hospital room are told in graphic detail. The athletically inclined doctor suffers many complications: exquisitely painful ulcers of the scrotum, mouth, and esophagus; inflammation of the liver; unexplained fever; drug-induced delirium; weakness and weight loss.

His parents, sisters and friends leap into action to provide round-the-clock presence, but his independent wife, Daniella, resents the invasion. While David’s body is wracked with drugs and radiation, his family and his marriage are subjected to destructive forces too. Yet all--body, family, and marriage--emerge intact, though changed, by their experience.

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Summary:

This anthology frames a rich selection of fiction and nonfiction with astute and helpful introductions to issues in nineteenth-century medicine and the larger culture in which it participated. The fiction is comprised of Mikhail Bulgakov’s The Steel Windpipe in its entirety; Sir Arthur Conan Doyle’s story, "The Doctors of Hoyland" from Round the Red Lamp; and selections from George Eliot’s Middlemarch, Gustave Flaubert’s Madame Bovary, Sarah Orne Jewett’s A Country Doctor, Sinclair Lewis’s Arrowsmith, Thomas Mann’s Buddenbrooks, W. Somserset Maugham’s Of Human Bondage, George Moore’s Esther Waters, Robert Louis Stevenson’s Strange Case of Dr. Jekyll and Mr. Hyde, Eugène Sue’s Les Mystères de Paris, and Anthony Trollope’s Doctor Thorne [the full-length versions of many of the above have been annotated in this database]. The nonfiction consists of two versions of the Hippocratic Oath, two American Medical Association statements of ethics, and selections from Daniel W. Cathell’s The Physician Himself (1905).

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Life-Size

Shute, Jenefer

Last Updated: Aug-30-2006
Annotated by:
Aull, Felice

Primary Category: Literature / Fiction

Genre: Novel

Summary:

This is a harrowing story, told in the first person, of an obsession with food and body image. "One day I will be thin enough", says Josie, the 25 year old anorectic woman who has been hospitalized for life-threatening self-starvation. "Just the bones, . . . the pure, clear shape of me." "One day I will be pure consciousness." The narration spins out in painful detail the pattern of compulsive behavior which pervades Josie’s existence. Her pitifully barren emotional life is revealed as well.

How did it all begin? Flashbacks of significant events invade Josie’s attempts to stop thinking. A shy, awkward adolescent, overly sensitive to casual comments about excess flesh, decides to diet. Josie stumbles non-communicatively through a teen-age sexual initiation to a later affair with her married professor, retreating ever further from her bewildered family.

But why do events take such an extreme turn? The mystery of anorexia nervosa remains. In the hospital, a nurse who has seen everything seems to strike some responsive cord, and Josie begins eating to gain weight. At the end of the novel she’ll soon be released , under supervision, but the outcome is in doubt. "Can I learn to be so present? Can I learn to be so full?" ". . . if I were a body, what would I be?"

 

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Island

Huxley, Aldous

Last Updated: Aug-29-2006
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Will Farnaby, reporter and underground agent for an oil magnate, is shipwrecked on the island of Pala, where for 120 years an ideal society has flourished. In the mid 19th century, a Scottish doctor successfully treated the enlightened Raja of Pala and settled on the island. These two men then designed a perfect society in which (according to the book jacket's description), "sex lives are unabashed; children are carefully conditioned from infancy and none is at the mercy of one set of parents; jobs are assigned according to physique and temperament," and everyone uses "moksha medicine," a drug that sharpens and deepens powers of consciousness.

The Palinese also practice hypnosis, eugenics, and a form of sexual yoga that leads to virtually perfect sexual experience. While Pala has enormous oil reserves, the people are uninterested in developing them because they are happy with their way of life and do not feel the need to become wealthier or more Westernized. Pala's companion island of Rendang is ruled by a ruthless dictator, Colonel Dipa, who plans to develop its oil resources and industrialize the island, while, at the same time, enriching himself.

After his shipwreck, Farnaby is injured climbing a cliff from the beach. He spends time recuperating, during which he meets a number of Palinese people, including Dr. MacPhail (descended from the original Scottish physician) and Murugan, the young man who will soon become the new Raja of Pala. As he learns more about the society, Farnaby comes to respect it and turns away from his plans to promote oil development on the island.

However, Murugan (who was raised largely in Switzerland by a fanatic mother who runs a fundamentalist Christian movement) frowns upon the sexual freedom, drug use, and general lack of "ambition" among his countrymen. He secretly conspires with Colonel Dipa to sell-out Pala. At the end of the book, the army of Rendang has invaded Pala and declared a joint kingdom of Rendang and Pala with Murugan as king and Colonel Dipa as Prime Minister.

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Summary:

This collection of sixteen Chekhov stories brings together in one volume many of Chekhov’s finest tales about doctors. The chronologically-arranged collection includes the famous novella, Ward 6, as well as such shorter classics as An Awkward Business and A Doctor’s Visit. In all sixteen stories, the doctor is a major figure, often at the center of a moral conflict.

Robert Coles , in his thoughtful forward, notes that Chekhov raises the "big questions" about "the meaning and purpose of life and the manner it ought to be conducted (and why)." Himself the editor of William Carlos Williams’s doctor stories, Coles recognizes and honors the comparison between Chekhov’s and Williams’s works and their dual careers as physician-writers. Jack Coulehan, in his introduction and comments, provides interesting biographical information on the great Russian writer as well as insightful interpretations of each story.

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Primary Category: Literature / Fiction

Genre: Novel

Summary:

As the story opens, Raphael enters a gaming house and loses the last of his money. He decides to drown himself in the Seine. As he waits for the crowds to leave the evening streets, he wanders into an antique shop, where he tells the shop keeper that he is going to kill himself and the man shows him a mysterious-looking skin hanging on a wall. It is inscribed with a message in "Sanskrit" that one who owns the skin will have any wish granted, but that each wish will cause the skin to shrink. When the skin disappears, its owner dies.

Raphael brashly decides to take the skin. He wishes for a rich dinner, a fortune, and women. As he leaves the shop, he is stopped by friends who invite him to a dinner. Raphael tells his history. He is the son of a fairly wealthy man, but he squandered his fortune. He has spent the last three years studying in a garret and trying to win the love of Foedora, a cold society woman. His garret was warmed by the friendship of Paulina, his landlady’s daughter.

As the dinner party ends, Raphael receives word that he has inherited a vast fortune. His wishes are coming true and the skin is shrinking. Raphael now clings to life and arranges it so that his servants supply his wants before he even realizes them. One evening, he encounters Paulina; she too has inherited money and he is struck by her maturing beauty. Foedora seems ugly next to Paulina’s purity. Raphael wishes that Paulina will love him. They marry, but the skin continues to shrink.

Doctors are called to treat Raphael as his health fails and they argue over whether his disease is caused by his mind or whether his mental obsession is caused by a physical disturbance. They cannot resolve the dispute, but as their patient is a millionaire they decide to treat him anyway. They suggest applying leeches and traveling to "take the waters."

Raphael does travel and at one point duels with another young man. He warns his enemy to ask his forgiveness for otherwise, Raphael’s bullet is bound to kill him while the others’ bullet will surely miss. The other refuses and Raphael, though he shoots randomly, kills him. He takes refuge in a country cottage, but still has desires which the skin satisfies without Raphael’s conscious intention.

He returns home to Paulina and tells her about the skin. Knowing he is going to die, he indulges in a final burst of passion for her. She sees that such desire will kill him and tries to kill herself to spare him, but fails. Raphael dies.

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A Fortunate Man

Berger, John; Mohr, Jean

Last Updated: Aug-21-2006
Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

The subtitle of this photographic essay is "The Story of a Country Doctor." Berger and Mohr give the reader an imaginative portrait of Dr. John Sassall, an English general practitioner who lives and practices in a remote rural community. The book begins with several stories of Sassall’s work with patients, gradually introducing the man himself and revealing his thoughts about his profession, his life, and the nature of healing.

Berger explores what people in the community think about this unusual doctor who has given up his chance to "get ahead" in the world in order to remain with them. They are sure he is a "good doctor," but what does that mean? How does one judge "goodness" in a physician? Berger comments in an impressionistic way on the nature of Sassall’s relationships with patients--a complex mixture of authority, fraternity, and intimacy.

The latter part of the essay expands its focus to the community as a whole and the nature of contemporary medicine. Throughout the book, Jean Mohr’s photographs serve as indispensable features of the story.

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A Doctor's Visit

Chekhov, Anton

Last Updated: Aug-17-2006
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

A junior doctor goes to visit the daughter of a wealthy factory owner. (The professor was too busy to go.) The daughter had been ill for a long time and had just suffered "heart palpitations" the previous night. At first the doctor finds nothing wrong with her heart, and says that her "nerves must have been playing pranks" on her.

The patient’s family presses the doctor to stay for the night. During the evening, he reflects on the oppression of the dreary factory town and relates the sense of loneliness and confinement ("like a prison") to his patient’s condition. Later, in conversing with the young woman, he actually listens to her empathically, rather than just focusing on her symptoms or the function of her heart. He is then able to respond empathically to the young woman’s plight.

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