Showing 141 - 150 of 473 annotations tagged with the keyword "Medical Ethics"

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.

View full annotation

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. 

 

View full annotation

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.

View full annotation

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.

View full annotation

Fat Lady

Yalom, Irvin

Last Updated: Jan-05-2009
Annotated by:
Wear, Delese

Primary Category: Literature / Nonfiction

Genre: Case Study

Summary:

This is the story of Betty, a 250-pound, 5-foot-2-inch woman who comes to the psychiatrist-narrator's office to be treated for her eating disorder. What makes the story more than the sad tale of a depressed, obese woman is the immediate disclosure of the narrator that he is "repelled" and "disgusted" by fat women, that his "contempt surpasses all cultural norms."

Nevertheless, he decides to treat Betty, who successfully manages to shed huge amounts of weight and come to terms with many of the problems leading to her obesity. The narrator, too, confronts his own excessive biases so that readers are left with a sense that Betty "helped" him too.

View full annotation

Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Collection (Short Stories)

Summary:

New York is the setting for thirteen linked stories that profile a long line of curious and sometimes loony doctors who are passionate about medical science but often lack common sense and good judgment. Beginning with Dr. Olaf van Schuler in the seventeenth century and continuing over more than 300 years with generations of his descendants (the Steenwycks), missteps and madness loom large in this inquisitive and peculiar medical family.

Most of these doctors share common goals: They strive to eliminate pain. They attempt to expand the scope of medical knowledge. They seek the soul. In their quest for cures and enlightenment, many of these physician-scientists, their relatives, and patients embrace off-beat diagnostic techniques or unproven remedies: phrenology, magnetism, bloodletting, hypnosis, radium-emitting apparatus, electrical shocks, and lobotomy.

In "The Siblings," a doctor performs a lobotomy on his sister. She dies a few months after the operation. In "The Story of Her Breasts," a woman develops rheumatoid arthritis that may or may not be caused by her silicone breast implants. She also experiences guilt and worry after encouraging her 18-year-old daughter to undergo breast augmentation. In "The Baquet," hope is undeniable and a miracle cure is mesmerizing. In the book's final story, "The Doctors," two physicians - a father and his daughter - grapple with their strained relationship and the man's progressive deterioration that might be due to Creutzfeldt-Jakob disease.

View full annotation

Summary:

When Jamie Heywood, the eldest of three brothers in a tight New England family of engineers, learns that his middle brother Stephen (they all are in their 20’s at the outset of this drama which begins, for them, in early 1998) has amyotrophic lateral sclerosis (ALS), he has just assumed the position of entrepreneur in technology transfer at Gerald Edelman’s Neurosciences Institute, the prestigious think tank of the 1972 Nobel Laureate in Physiology and Medicine, in La Jolla, California.

Jamie quickly announces his resignation and simultaneously his decision to devote his life to helping his brother in the only way he can--as manager, CEO, COO and staff of, initially, a loosely organized team effort to develop a cure for ALS, an insidious wasting disease of the nervous system that progressively leaves the person with the merest remnants of voluntary motor function.

Jamie’s resignation and his move from the West to East coast is but the mildest of changes in the weather for what becomes a perfect storm of technology recruiting, fund-raising, career-rebuilding and the emotional equivalents of El Niño, profoundly affecting at least four families, three of them Heywoods: Stephen Heywood, the strapping carpenter/house-restorer with ALS, and his wife, Wendy; Jamie, and Melinda, his belly-dancing wife with a PhD in medieval French literature; the brothers’ mother, Peggy, and father, John; and, lastly, the author and his father, Jerome, and mother, Ponnie (a Polish diminutive).

Concomitant with Stephen’s development of ALS, Ponnie begins to evidence the dementia of Steele-Richardson-Olszewski syndrome, also known as progressive supranuclear palsy, a form of brain decay uncannily similar to ALS. (Fortunately for the Heywoods, ALS involves only the motor nerves, not the cognitive apparatus.)

The author’s decision to include his family’s ordeal is wise, generous and instructive. The Heywoods and Weiners are both engineering families with an academic engineer as the pater familias and both are trying their best to cope with a deteriorating illness that dismantles the center of all cerebral engineering activity, the brain. The comparison of the diseases and the responses of all the players involved are culturally and psychologically dissected with the author’s trademark precision and kindness. But this book, as the title indicates, is more about the keeper than the brother.

Within minutes of his learning of Stephen’s diagnosis, Jamie becomes a man possessed. He moves quickly, as though by intuition and almost a fated skill, from technology transfer to technology-bricolage; genetic therapy on the fly; and people-, funding- and support-transfer. In fact, when there is no transfer involved, Jamie creates in order to transfer.

Like Gregor Samsa, in the short story by Franz Kafk, from whom Weiner also deftly borrows another parable, "An Imperial Message," (to illustrate, metaphorically, the pathophysiology of ALS as a disease in which neural messages, like the Imperial Message, go awry), Jamie undergoes a metamorphosis, albeit admittedly much less drastic than Gregor’s. He molts his undergraduate degree in engineering at MIT to emerge as a self-appointed manager of any and all ALS research and gene therapy in the U.S. that might help retard the progress of his brother’s illness.

Recruiting, petitioning, nourishing, cajoling, funding, and courting researchers and clinicians alike, Jamie meets, entertains, enlists and co-ordinates the efforts of gene therapy researchers and other medical scientists. He becomes a fund-raiser with the help of Melinda and her family of belly dancers, raising $240,000 as a result of the First Annual Belly Dance Extravaganza. His efforts involve the Heywood and Weiner family members, as epicentric waves of activity inevitably affect them all.

We watch, through Weiner’s eyes (and the diaries of Wendy and Melinda, whom he cites with permission), as the four families experience the predictable mood shifts that accompany a devastating illness and the great adventure of a risky attempt to work a miracle (a miracle that Jerome E. Groopman grumpily and stuffily bemoans in a cited Wall Street Journal editorial): excitement when a genetically engineered ALS mouse outlives its cohorts and money starts to flow; and disillusionment, when Stephen’s disease relentlessly progresses, Jamie’s marriage dissolves for a lack of boundaries, as Melinda, Jamie’s wife, records in her diary, and the author’s mother slips deeper into a dementia that Lucretius, Weiner’s authorial inspiration of the book, would easily recognize as part of the world explored in his famous treatise De Rerum Natura.

By the end of the book, there is an air of exhaustion yet surprising calm--perhaps the calm after the storm--as we witness the normalcy of Stephen, in his motorized wheelchair, playing with his son. As Stephen repeatedly affirms to Weiner, now a family friend and no longer merely a reporter, "I’m fine."

View full annotation

Before the Operation

Gervex, Henri

Last Updated: Nov-14-2008
Annotated by:
Aull, Felice

Primary Category: Visual Arts / Painting/Drawing

Genre: Oil on canvas

Summary:

Also called "Dr Péan Teaching His Discovery of the Compression of Blood Vessels at St Louis Hospital," the scene takes place in a room in which the walls are interrupted by tall windows.  Daylight shines through the windows, illuminating an attractive naked young woman in the right foreground who lies seemingly anesthetized -- her eyes are closed although there is no sign of anesthesia -- on a bed of some kind that is draped loosely with sheets.  Her body is pointing away from the viewer, her head facing away from us, her long hair falling casually over the near edge of the bed.  Her breasts are fully visible, especially her right breast, while her lower body is covered.  A seated man grasps the wrist of her bent right arm, perhaps taking her pulse. His hand and arm rest directly on the woman's body -- on her abdomen and groin area.  He appears to be reading from a paper.

In the left foreground is the edge of a table that holds some surgical instruments and a glass jar containing what may be anatomic specimens.  An imposing sideburned man stands to the left, above the head of the bed and the woman.  Holding a surgical instrument in his right hand, he gesticulates with his left-hand, his mouth partly open: he is lecturing to the people in the room, some of whom are looking directly at him while others talk to each other.  Two in the audience are women -- a nun barely visible in the far background, and a nurse standing behind two men who are near the bed.  The men are all dressed in street clothes.

View full annotation

Summary:

This is a collection of Elizabeth Layton's work, organized chronologically from 1977-1991. Contents include a biography and epilogue by a 27-year-old reporter (Don Lampert) who discovered, promoted, and became a dear friend of "a depressed grandmother with a handful of drawings under the bed."

Layton discovered contour drawing when she was age 68 and claims to have drawn herself out of mental illness. Her subject matter is self-portraiture, marriage, aging, depression, grandmothering, dieting, and political commentary (nuclear holocaust, capital punishment, mythology and hospital death).

View full annotation

The Hospital Poems

Ferris, Jim

Last Updated: Oct-15-2008
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

The first poem begins: "Let me be a poet of cripples, / of hollow men and boys groping / to be whole, of girls limping toward / womanhood. . . " This Whitmanesque introduction bespeaks two sides of Jim Ferris’s poetry. First, this is poetry of celebration: "I sing for cripples, I sing for you." But at the same time, the poems look unflinchingly at the failures, phoniness, and self-righteousness of the "fix it" establishment. They also portray (and celebrate) the community of suffering among the inmates destined to be "fixed."

In "Meat" (5) Ferris lays it on the line," Between four and five they bring down the meat / from recovery--those poor dopes have been simmering / up there for hours, bubbling up to the surface. . . " But even the children who have become "meat" have feelings. For example, the narrator of "Mercy" (18) expresses horror when two healthy classmates from the 8th grade manipulate the hospital rules in order to bring him a Get Well greeting. "How did these aliens get in?" he asks. "Leave now, trespassers, you who seek to gaze / on my humiliation." Perhaps the merciful will obtain mercy from God, he comments, "but not from me." In "Miss Karen" (25) the narrator sustains himself with erotic fantasies about his nurse and discovers to his mortification that he babbled these thoughts to his mother during recovery from anesthesia.

The culture of medicine looks cruel--or at least uncaring--though this crippled narrator’s eyes. "The Coliseum" (42) gives a telling description of the patient’s appearance at Grand Rounds: "You are a specimen / for study, a toy, a puzzle--they speak to each other / as if you were unconscious. . . " "Standard Operating Procedure" (44) reads like an ironic crib-sheet for orthopedic surgery: "Bust a chuck / of bone the rest of the way out; chisel it if you have to. . . He won’t remember much; kids are like animals / that way."

View full annotation