Showing 131 - 140 of 470 annotations tagged with the keyword "Medical Ethics"

Summary:

John Romulus (also known as Richard) Brinkley was a physician (in the diploma-mill sense of the word) who, in 1917, pioneered, in the U.S. at least, the notion of goat testicle transplant. "Transplant" must be understood in the loosest sense of the word since Brinkley simply removed the testicles from young goats and sewed them into the abdominal wall and scrotal tissues - without any attempt to connect blood or nervous tissues of either goat testicles or human  - of men for the alleged purpose of relieving impotence. From 1917 until his downfall at the hands of Morris Fishbein, a medical crusader esconced in the AMA, which organization Dr. Fishbein helped establish as the premier advocate of organized medicine in the U.S., Dr. Brinkley was perhaps the most recognizable physician in the U.S.

He ran for the office of Governor of Kansas in 1930 (losing by technicalities that today would have overturned the results), and established the most powerful radio station in the land, XERA, that promulgated his glandular chicanery all across the continental U.S. As a proponent of such skullduggery, Brinkley was continually in the sights of Dr. Fishbein, whose main reputation nationally was as an exposer of medical fakery. Eventually Fishbein lured Brinkley into a libel trial that resulted, in 1939, in the catastrophic downfall of an immensely talented and wealthy man who spiraled into bankruptcy and death in 3 short years.

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Annotated by:
Davis, Cortney

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Author Jennifer Culkin has been involved, for all of her nursing career, in high stakes, heart stopping, instant-decision-making areas of critical care.  After years working in Neonatal Intensive Care, she became a flight nurse--and giving intensive care to trauma victims while trying to maintain balance and sterile technique in a wind-buffeted helicopter has to be one of the most difficult tasks a nurse might undertake.  Her memoir, A Final Arc of Sky, opens with such a scene.  The patient, Doug, is soon crashing, and the nursing team, Jennifer and her partner, have to make a series of tough decisions (pp. 8-12).  From this scene on, the action rarely wavers.  And although Culkin keeps the pace moving, she is not always, or even most often, telling us about similar traumas.  She deftly weaves her personal narrative--husband and sons and dying parents--in and out of scenes from her nursing career, braiding the plot lines of her life in chapters both moving and compelling. 

In those chapters that deal with the often dangerous helicopter transports Culkin has flown, we learn (and we feel) just what it's like to be a flight nurse crammed in-between patient and helicopter door, juggling instruments that too often slip to the floor and trying to save patients that too often want to die.  In those pages that deal with family, we are privy to Culkin's internal debate about how to separate family from nursing (what she calls "the great neuronal divide between my work and my life" (p.136), and we see that she sometimes doesn't have much energy left at the end of the day to draw close to those she loves.  Part of what makes this memoir difficult to put down is the persona of the narrator herself: Culkin comes across as an honest, often irreverent risk taker, a woman who likes to ride her bike down dangerous hills at breakneck speed and allows her son to do the same (see chapter six, p. 57); a woman who loves the dangerous drama of flight nursing and doesn't worry about crashing (p. 80)--in fact she enjoys strapping herself "into the eye of a maelstrom" (p. 80). 

This memoir entertains, and it provides a glimpse into how some caregivers not only risk their lives to save the lives of others but also shoulder the responsibility of making split second decisions upon which a patient's life might depend.  And there is a surprise in this memoir, one that I can't too fully divulge because to do so would be to rob potential readers of their own discovery.  Suffice it to say that near the end, Culkin reveals something about her own health, an illness she has fought against in every chapter.  When we learn the details of her own illness narrative, we look again, with new understanding, at her fascinating career and her interactions with her loved ones.   

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Mind Talk: The Brain's New Story

Drake, Bob

Last Updated: Mar-10-2009
Annotated by:
Shafer, Audrey

Primary Category: Performing Arts / Film, TV, Video

Genre: Video

Summary:

This documentary film explores the interdisciplinary quest to understand the mind--its relationship to the brain, to the soul, to consciousness and sentience, and to the societal implications of free will. The film begins with the crisscrossing flow of people in a train station and an overvoice expressing the existential questions of "who are we?" and, ultimately, "who am I?"

This compelling image, filmed in black and white, serves as a representation of people as humanity and as individuals, as well as a metaphor for flow, such as of time or of impulses along a neural network. Hence, already in the introduction, the viewer is aware that this film will address some of the deep philosophical questions of all time complemented by visual imagery which enhances and enlarges on the dialogue.

The film is then divided into twelve sections: The Soul, The Body, Mental Disorder, Mind to Molecule, Bit to Brain, Consciousness, Free Will, Citizenship, The Moral Brain, The Brain on Trial, The Medical Mind, and Who Am I? Experts from multiple fields such as theology, neuroscience, psychiatry, law and justice, philosophy, sociology, history of medicine, physics, computer science, and filmmaking offer insights and questions either directly to the camera, or as voice-over for other imagery.

For example, to name just a few of the numerous eminent persons in the film, there are statements by mathematical physicist Roger Penrose (Shadows of the Mind: A Search for the Missing Science of Consciousness, and The Emperor’s New Mind: Concerning Computers, Minds and the Laws of Physics), philosopher Daniel Dennett (Darwin’s Dangerous Idea: Evolution and the Meanings of Life, and Brainchildren: Essays on Designing Minds), philosopher John R. Searle (Mind, Language and Society: Philosophy in the Real World) and neurologist Antonio Damasio (Descartes’ Error: Emotion, Reason and the Human Brain). The multiple experts all address the basic question posed by the film: "What will a science of the brain add to the human story?" but the approaches to the question, and what aspects of the question are most important, vary considerably in this far ranging journey through religion, history, ethics, medicine and science.

A few of the many interesting segments of the film include sections on cognitive neuroscientist Nancy Kanwisher who studies specialization by parts of the brain, such as a face-recognition center; developmental neuroanatomist Miguel Marin-Padilla, who has studied the motor cortex for over 25 years, which he demonstrates by dissection to be smaller than the tip of his finger; and Dennett’s one-armed robot, Cog, which is "learning" in developmental stages as an infant would. Eloquent commentary is also provided by computer scientist Jaron Lanier, sociologist Howard Kaye, psychologist Nicholas Humphrey, and filmmaker Ken Burns, among others.

Much of the film deals with psychopathology and implications for morality, behavior, and responsibility for behavior (free will and crime). Segments include an interview with a patient with manic-depressive disorder, a historical note on Phineas Gage (whose dramatic wound of his frontal lobe so altered his behavior), and a lawyer, psychiatrist and judge discussing free will, diminished capacity, and the legal system.

The film concludes with some concerns about reductionism to the biologic model of the mind, the growing haziness of borders between human and artificial intelligence, and the role of psychoactive medications. Although full mapping of the brain may not lead to complete understanding of the mind, still, the film concludes, the quest is fun.

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Body Language

Studer, Constance

Last Updated: Mar-10-2009
Annotated by:
Davis, Cortney

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Body Language, a beautifully crafted and expansive memoir by retired nurse Constance Studer, spans a range of issues within the narrative of the author's life: a childhood marred by a medical procedure--a hasty frontal lobotomy that left her father incarcerated in a mental institute-- and, in later years, by her own illness, one caused by the Hepatitis B vaccine.  These two events are the bookends that frame Body Language, a memoir that examines family life, nursing, medicine, medical ethics, personal survival and illness in language that is poetic and compelling.  Studer, a writer as well as a nurse, intersperses her own story--which is novel-like in its intensity--with literary allusions, research material and knowledge culled from her years as a nurse in Intensive Care.  In her memoir, she writes not only with the authority of one who has been on both sides of the bed, as professional caregiver and as suffering patient, but also as a family member who has witnessed how unwise and unchallenged medical decisions might affect generations. 

What I especially admire about this memoir is that it is not simply a "telling about."  Instead Studer brings us into the action of the narrative, for example giving us imagery and dialogue as her father prepares for the surgery that he doesn't know will deprive him of memory and sense ("Holy Socks" p. 21).  She also intertwines many narrative strands, giving us the fullness of her family history and her professional adventures, so that when we reach the narrative of her own illness we have a sense of a life, a full life, that has been forever altered.

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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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Bioethics at the Movies

Shapshay, S., ed.

Last Updated: Feb-20-2009
Annotated by:
Henderson, Schuyler

Primary Category: Literature / Nonfiction

Genre: Anthology (Essays)

Summary:

Intended to "spark a philosophical dialogue among readers and in classrooms, clarifying, refining, and challenging the ethical positions people hold on a great many bioethical topics"(1), Bioethics at the Movies contains 21 essays discussing bioethical issues, from abortion and cloning to disability narratives and end-of-life care, in relation to various films. The two dozen authors come from the United States, Spain, Australia, Israel and the United Kingdom, and the majority have their academic homes in Departments of Philosophy. For the most part, the essays use one particular film as a springboard to discuss a bioethical topic, such as terminating pregnancies (The Cider House Rules), marketing organs (Dirty Pretty Things), and memory deletion (Eternal Sunshine of the Spotless Mind). Two films get a pair of essays (Gattaca and Million Dollar Baby), and several authors cover more than one film. In addition to the aforementioned films, Wit, Citizen Ruth, Bicentennial Man, I, Robot, Babe, Multiplicity, Star Trek: Nemesis, Ghost in the Shell, Dad, Critical Care, Big Fish, Soylent Green, Extreme Measures, Talk to Her, and Ikiru are closely covered.

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Annotated by:
Henderson, Schuyler

Primary Category: Literature / Nonfiction

Genre: Criticism

Summary:

Originally delivered as a ten-hour lecture at a conference and subsequently partly published in various forms, The Animal That Therefore I Am has been collected in this one volume, also including a transcription of Derrida's extempore lecture, delivered at the end of the symposium, on the 'animal' and Heidegger. The Animal That Therefore I Am is a sustained meditation on the role of the 'animal' in philosophy.  Derrida questions the logic, the ethics, and the rhetorical and philosophical effects of establishing (or assuming) a boundary that seems to distinguish so clearly, so finally, and so permanently the human from the animal.

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Indestructible

Byer, Ben

Last Updated: Feb-14-2009
Annotated by:
Schilling, Carol

Primary Category: Performing Arts / Film, TV, Video

Genre: Video

Summary:

When diagnosed with Amyotrophic Lateral Sclerosis (ALS) at age 36, filmmaker Ben Byer began recording a video diary.  Episodes from his diary create the engaging, coherent narrative of "Indestructible," a documentary that intimately, but unsentimentally invites viewers to witness Byer's and his family's responses to his diagnosis.  Their first impulse is to search for a cure for this degenerative disease, "the grim reaper of neurological diseases," a physician tells him.  They also find themselves seeking ways to understand living with loss, most centrally losing the illusion of control over their lives. 

Over the course of three years Byer and family travel to six countries, including Greece, China, Tibet, and Israel.  During his journey, Byer, an irrepressible extrovert, also seeks the companionship and insights of other ALS patients and families, wishing to create a world-wide bond among people who struggle daily.   A montage of clips from family videos prefaces the film, revealing Byer in the decades before his diagnosis.  The images show a luminous child, who grows into a playful, photogenically handsome teen ager and young man, husband, father, son, and brother.  His exceptional force of personality, incandescent smile, and spontaneous sense of humor fill the screen.  These robust images contrast touchingly with the thinner, clumsier Byer who later struggles to remove a t-shirt.  But they also reveal continuities between Byer's capacity to enjoy his life during seemingly carefree days and his strength of spirit as he becomes increasingly more disabled, disappointed, and introspective.  Although even such strength can't alter his condition, it nonetheless sees him through to the next day and fresh adventure.

The family in the montage and the film emerge as Byer's source of support as well as conflict.  One of the most devastating conflicts arises from his father Steve's restless determination to find treatments to reverse or retard ALS.  After searching the Internet for remedies, Steve turns his garage into an ad hoc distribution center for an herbal concoction he encourages his son to drink.  To advance his son's place on the waiting list of a Chinese neurosurgeon who performs olfactory cell transplantation, he recruits other ALS patients for the procedure.  The results are dubious, in some cases perhaps fatal.  After these strategies fail to reverse Byer's physical decline, and place others at risk, the camera rolls during a family showdown that exposes their fears and desperation as it acknowledges their love.  This memorable scene does so in a way that's consistent with the rest of the film: by letting the camera show, not tell. 

Even the many moments when Byer's family help him with daily activities and his most reflective moments at the end of his film resist sentimentality and easy didacticism.  Byer's equally irrepressible young son John raises a fork wound thick with pasta to his father's mouth and loops his belt through his pants, setting off giggles all around.  The ordinariness and extraordinariness of these acts, the learning of selflessness, the uneasy acceptance of dependency, the inevitability of loss are told through such images or captured in fragments lifted from daily conversations.  Bathing Byer, his brother Josh matter-of-factly says, "You don't have all the time in the world":  a searing acknowledgment of Byer's decline that reminds us of all human fragility.  The closing scenes of the film unobtrusively place Byer's solitary experience in the long history of the search for meaning in human struggle.  They record his wobbly, yet victorious ascent of Masada, supported by Josh, right after we hear a rabbi recount Camus's version of the myth of Sisyphus. 

 

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The Good Physician

Harrington, Kent

Last Updated: Feb-05-2009
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Spoiler Alert: The ending of this thriller is revealed in the final paragraph of the summary. The threat of terrorism and the moral code of a physician place Dr. Collin Reeves in a very difficult position. The young American doctor is a specialist in parasitology and tropical diseases. He has trained and worked around the world - London, Kuwait, Brazil, and Africa. He presently practices in Mexico City. The U.S. Embassy refers sick American tourists to him. Dr. Reeves is also a CIA operative who enlisted after 9/11 to fight terrorism. After two years as an employee of the U.S. Intelligenge Service, he is disenchanted and wants out. Dr. Reeves is appalled by the brutal handling of terrorist suspects. It is his job to treat them and keep them alive long enough to obtain information or a confession.

Dr. Reeves loves Mexico, painting, and living day to day. He hates arrogance, disease, and human misery. His boss, Alex Law, is the chief of the CIA station in Mexico. He and his pal, Butch Nickels, have been in the spy business a very long time. Law is an alcoholic. His wife finds a lump in her breast that proves to be malignant. Dr. Reeves and his father (a surgeon practicing in San Francisco) arrange treatment for the woman in California where she undergoes a double masectomy.

Law has some clues that a group of al Qaeda in Mexico are plannning an attack. He worries they intend to bomb a city in California. Law's intuition is pretty good. A husband (Mohammad) and wife (Fatima) from Baghdad are set on revenge. Their young son was killed by an American bomb in Iraq. The husband, a physician, was mutilated by the same bomb. Unaware of her true background and her mission of destruction, Dr. Reeves falls in love with the beautiful woman who calls herself Dolores Rios. At one point, he kills a policeman and wounds another to rescue the woman. When her husband is bitten by scorpions, Dr. Reeves saves his life.

Members of the al Qaeda cell eventually capture Dr. Reeves and some of his friends. They plan to crash a stolen airplane into a California city. Dolores has a change of heart, but her husband is intent on revenge and becoming a martyr. Dr. Reeves offers to accompany the terrorists in exchange for Dolores being left behind. Still recovering from the effects of the scorpion bites, Mohammad figures it might be wise to have some medical expertise readily available. Shortly after take-off, Dr. Reeves manages to crash the plane but he is killed by gunfire in the process. The terrorist attack is averted. When Alex Law locates Dolores, he allows her to go free and start a new life. The doctor would have wanted it that way and Law allows him that much.

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Summary:

The film opens with the discovery of Dr. Victor Frankenstein's will in his Transylvanian village. A skeleton, presumably Dr. Frankenstein's, and a man wrestle for the box holding the will. The man wins, takes it to a town meeting where the will is read and calls for the transfer of the property to the dead scientist's grandson, Frederick. Following this scene we meet the grandson, Dr. Frederick Frankenstein (Gene Wilder), a surgeon who is busy instructing medical students in clinical neuroanatomy (comparing the brain to a cauliflower). When asked about his grandfather by a medical student, Freddy, who pronounces the family name "Fron kon steen", declares that Victor was "a cuckoo". The student is relentless in pursuing the family ties, exasperating Freddy, who finally plunges a scalpel into his thigh, a sight gag paying homage to Peter Sellers' stabbing himself with a letter opener in A Shot in the Dark (1964). When the courier from Transylvania arrives, he persuades Freddy to return to his ancestral castle for the execution of the will. A hilarious railroad platform scene in which Freddy bids goodbye to his "beautiful, flat-chested" (as described in the online original etext of the script by Gene Wilder) fiancée, Elizabeth (Madeline Kahn), only highlights the incredibly neurotic natures of the two lovers -- Wilder as a possessed but wacky scientist and Kahn as a narcissistic and apparently remote and shallow woman.

In Transylvania, Freddy and the viewers meet the remainder of the major characters. Inga (Teri Garr), a bosomy and mindless but beautiful and dedicated blonde, escorts him to the castle, where he meets the hunchback Igor, played by the incomparable Marty Feldman, who instructs Freddy, with one of the lines all Young Frankenstein addicts love to quote, to "walk this way", by which he means with a limp and a cane, not directions to anywhere at all. After remarking that the huge castle doors have huge knockers (which they do) -- which Teri Garr winsomely mistakes for a compliment on her equally huge knockers -- Freddy and his entourage enter the castle and meet Frau Blücher (played magnificently by Cloris Leachman), the spinster who keeps the castle, nourishing an undying flame for Freddy's dead grandfather. Soon Freddy and Inga discover, by means of a secret passageway behind a  -- surprise! surprise! -- revolving bookcase wall in Freddy's room, his grandfather's hidden subterranean laboratory (Brooks used the same electrical apparatus as the 1931 Frankenstein film) and scientific journals. With the materials and methods now at hand, Freddy undergoes a spiritual transformation, embracing his forebear's obsession with creating life from dead bodies, rejecting his earlier rejection of Victor's work as "Doo-Doo!".

At this juncture we move into the scientific creation mode and of course meet the Monster, exuberantly portrayed by the talented Peter Boyle. When Igor tries to steal a brain from a neighboring morgue there occurs the infamous mix-up of an "Abnormal" brain (labelled "DO NOT USE THIS BRAIN!") for the intended brain of H. Delbrück ("the finest natural philosopher, internal medicine diagnostician and chemical therapist of this century" and also the author of 17 cookbooks) making at least this viewer wonder if Mel Brooks had in mind a real scientific genius, Max Delbrück, who had received, only 5 years before, a Nobel Prize in Physiology or Medicine in 1969 for his work on bacteriophages.

The predicted spoofs ensue: the actual process of transforming the very large corpse of Peter Boyle into the very large body of the living Monster (with Inga remarking, after Freddy states that for the experiment to be a success, the monster must have enlarged body parts, that he "vould have an enormous schwanzstucker" -- a pseudo-German/Yiddish word that everyone in the audience immediately comprehends); the inclusion of Gene Wilder's rendition of the legendary exclamation, "It's alive!" by Colin Clive in the 1931 Frankenstein; the monster's mercurial disposition; the wildly comic scene with the Monster meeting the Blind Man (Gene Hackman); the Monster's fascination with music and antipathy to fire -- they all give rise to set pieces of Brooks's unique mix of lowbrow comedy with intellectual puns, Yiddish asides and the ubiquitous combination of visual and physical jokes.

After Elizabeth unexpectedly arrives in Transylvania we witness an apparently unlikely, and therefore uproariously believable, liaison with the Monster outside the castle, with Madeline Kahn eventually taking on the classic Marge Simpson type hairdo of Elsa Lanchester in the 1935 Bride of Frankenstein. The last important scene before the ending involves Freddy nostalgically summoning the Monster back to his natal castle for a transference of Freddy's calm brain to the Monster's. The ending, with the Monster a fully acculturated and now sophisticated man about town, and with Freddy and Inga still in love in Transylvania, is a brilliant win-win result for Freddy, Inga, Elizabeth and the Monster, although hardly predictable. Without giving away too much of the denouement, suffice it to say that the movie ends on a high note transforming, as it were, a linguistic pun into a musical one.

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