Showing 141 - 150 of 262 annotations tagged with the keyword "Infectious Disease"
This collection of stories describes "a medical student's journey" (the subtitle) through the difficult terrain of clinical education. In Audrey Young's case, this is also a geographical odyssey from Seattle to Swaziland to Pocatello, Idaho, as she completes her University of Washington clinical rotations and electives. In one sense the main characters of these narratives are the patients the author encounters in clinics and hospitals. As she writes in the Preface, "Patients teach things that the wisest and most revered physicians cannot, and their lessons are in this book."
In another sense, of course, Dr. Young herself is the central character of these stories; this is an account of her journey into doctoring. The author first takes us to Bethel, a Yupik Eskimo town on the Bering seacoast of Alaska, where she had her initiation into clinical experiences in the form of a summer preceptorship. There she learns that patients are far different from textbook examples, as she confronts the social and cultural factors that influence illness and its amenability to treatment. We follow the author to assignments throughout the WWAMI network. WWAMI is the University of Washington's decentralized clinical training program (Wyoming, Washington, Alaska, Montana, and Idaho).
In Spokane she delivers a baby for the first time, supervised by an opera-loving attending physician. In Pocatello she takes care of her first critically ill neonate. In Missoula her life becomes "one of resigned solitude" in her internal medicine clerkship, where she experiences sleep deprivation and experiences sunlight only "through dusty windows."
During her fourth year, the author finds herself treating desperately ill AIDS patients without a supervising physician (he had gone to Zaire for a funeral and might be back the following week) and also without anti-retroviral drugs. However, it is in Swaziland that she learns the deep power and dignity of medicine, as exemplified by a patient who invites her to a dinner in her honor that requires killing one of his precious chickens.
In 1918, the lives of ordinary Americans are disrupted by two cataclysmic events--an epidemic of influenza and World War I. Lydia Kilkenny is a young woman who works in a Boston department store. She falls in love with Henry Wickett, a sensitive and sickly man who is enrolled in medical school but has little enthusiasm for becoming a doctor. After marriage, Henry drops out of medical school. He tries to enlist in the army but is rejected.
Henry turns his attention to "Wickett’s Remedy"--a tonic accompanied by a handwritten letter emphasizing hope and encouraging recovery. Lydia designs the product’s label and concocts the placebo (based on ingredients revealed to her in a dream). The Remedy is an unsuccessful business venture for the couple.
A businessman named Quentin Driscoll likes the taste, however, and sells the Remedy as a beverage (QD soda). Although Driscoll promises to share future profits from the sale of the soda pop with Henry and Lydia, he fails to honor the agreement. QD soda eventually becomes quite popular, but Lydia never reaps any of the financial gain.
Influenza claims the lives of the two most important men in Lydia’s life--her brother, Michael, and her husband, Henry. She feels helpless and decides to volunteer at the local hospital where she cares for patients with the flu. Lydia realizes that she wants to become a nurse and signs up for a Public Health research project investigating how influenza is transmitted. Unfortunately, none of the test subjects (Navy deserters) contract the flu during the study, but a promising young doctor dies of influenza and pneumonia. Lydia later marries one of the men she meets during the research project.
Martin Arrowsmith is from a tiny mid-western town. He goes to college and then to medical school in the largest town in the state. He begins to worship Gottlieb, Professor of Bacteriology, one of the few professors who is devoted to pure science instead of lucrative practice. Martin becomes Gottlieb’s assistant and annoys his professors and friends by constantly talking about methodology. He is engaged to Madeline, a rather dull graduate student in English. When he meets Leora, a nurse, he breaks his engagement to Madeline. Martin grows disenchanted with his career, leaves school, and wanders around the midwest. Finally, he marries Leora and returns to school. Now, however, he becomes a disciple of the Dean, Silva, whose science is much less precise and who is devoted to making people comfortable at all costs.
Martin sets up practice after graduation in Leora’s home town. The Swedish and German farmers find him invasive and unwilling to cater to their small-town expectations. When Martin misdiagnoses a case of smallpox, he is forced to leave town. He has by then found a new hero, Gustave Sondelius, who fights plagues abroad and returns to America to lecture. Sondelius finds him a job in a larger town as an assistant to Dr. Almus Pickerbaugh, Director of Public Health. Pickerbaugh writes popular poems against sidewalk spitting and alcohol but does little else. The town loves him. He becomes a senator and Martin takes over the department. He quickly makes enemies of the very people Sondelius pleased. He also returns to research. Between annoying the upper crust with his brusqueness and annoying the farmers by closing their diseased dairies, he is soon drummed out of town.
He is then hired as a pathologist at the Rouncefield Clinic, where he does meaningless, repetitive work. His old mentor, Gottlieb, saves him by getting him a position at the McGurk Institute in New York. The Institute is very rich and gives scientists a chance to work without the interruption of patients or a need for practical application. Martin returns to Gottlieb’s principles and discovers a cure for bubonic plague. The Institute, which is not free from economic interests, sends him off to the tropical island of St. Hubert to test his material and save the population.
Martin is determined to conduct a controlled trial. When his wife and Sondelius both die of the plague, however, he injects everyone, saves the island, and returns to New York. Gottlieb has dementia and can neither blame nor forgive Martin for his lack of scientific aplomb. Martin marries an heiress and briefly lives the rich life he always dreamed of, but finds that his new wife will not let him work. Finally, he joins a friend who has built a laboratory in Vermont and happily returns to research.
Thirteen-year-old Charles has been sick with a fever for days. The family doctor makes house calls and diagnoses the problem as scarlet fever and a cold. The boy is unconvinced and questions the physician's certainty since no diagnostic tests have been done. Charles is terrified when first his hands and then his legs change. He senses that his extremities become swollen, warm, throbbing, and twitching. Although the limbs appear normal, Charles is sure that he no longer has control of them. Recalling how the wood of petrified trees transforms into stone, he now fears that his entire body has been irrevocably replaced by a propagating mass of microbes.
The doctor dismisses the boy's fright as the result of fever and imagination. He placates Charles by giving him pills. When Charles begins choking himself, his parents restrain him in bed. Fortunately, the teenager improves dramatically. His fever disappears, and he is suddenly robust. Yet there is something odd (and a bit creepy) about Charles following his recovery.
The Bacteriologist has a visitor to his laboratory, a pale stranger who arrives with a letter of introduction from a good friend of the scientist. The scientist shows his visitor the cholera bacillus under a microscope and they talk about the disease. The visitor is particularly interested in a vial containing living bacteria, and the scientist describes the power of cholera, saying what a terrible epidemic could be caused if a tube such as the one he holds were to be opened into the water supply.
The scientist's wife calls him away for a moment; when the scientist returns, the visitor is ready to leave. As soon as the visitor has gone, however, the scientist realizes the vial of bacteria is missing, that the visitor must have stolen it. He runs out in a panic, sees the visitor's cab leaving, and hails another cab to give chase. The scientist's wife, horrified by his inappropriate dress and hurry, follows in a third cab, with her husband's shoes and coat and hat.
We shift to the point of view of the visitor in his cab. He has indeed stolen the vial. He is an Anarchist who plans to release the bacteria into London's water supply. His motivation is fame: he feels he has been neglected by the world, and now he will reveal his power and importance. In the speeding cab, however, he accidentally breaks the glass vial.
He decides to become a human vector. He swallows what is left in the vial, and stops the cab, realizing that he no longer needs to flee. When the scientist catches up and confronts him, the Anarchist gleefully announces what he has done. The scientist allows him to walk away, and tells his wife that the man has ingested the stolen bacteria.
There is a twist: the vial, it turns out, did not contain cholera, but a strange new microbe the Bacteriologist had been studying, the only known effect of which is to make the skin of the animals exposed to it turn bright blue. The Bacteriologist reluctantly puts on his coat and returns home with his wife, complaining that he will now have to culture the bacillus all over again.
A chronicle of the author's perceptions, thoughts, memories, and personal relationships during the months after he was diagnosed as having AIDS. Brodkey's mind and prose are as sharp as a knife's edge. Beginning with the desperate struggle for breath that signaled pneumonia and, retrospectively, "how my life ended. And my dying began," continuing with the reactions and decisions of himself and his wife, the first half of the essay spins out an observant, introspective, cerebral, even amusing account of his particular experience.
But AIDS is often a disease associated with more emotional baggage than other fatal illnesses, and in Brodkey's case we learn that he traces both his dying and his homosexual experiences to "the major drama of [his] adolescence", daily sexual abuse by his adoptive father, with the implied knowledge and acquiescence of his mother. Writes Brodkey, "I experimented with homosexuality to break my pride, to open myself to the story." "Now I will die disfigured and in pain."
The Way We Live Now consists entirely of fragments of conversation among friends concerned about a friend with AIDS. They confer on the telephone, over coffee, in the halls of the hospital, about the patient and his illness. They speculate, prognosticate, share anxieties, trade innuendoes of guilt and blame, pool their medical knowledge, and criticize the medical establishment.
The patient never appears, and indeed, we never meet a fully-fledged character, but only hear the orchestra of voices that wryly and accurately reflect the mediated and fragmented character of modern community life. News travels among them like an electric current, carrying shock waves of fear and pain. Their pooling of medical lore results in an eclectic mix of remedies that reach from chicken soup to the patient's favorite jelly beans.
By the end, several of the characters, represented only by voices in the conversation, have had to come to terms not only with the impending loss of their friend, but with their own various and unsettling responses. The disease, clearly AIDS, is never mentioned by name.
This is the last published entry in the journal kept by author Harold Brodkey, before he died of AIDS on January 26, 1996. Brodkey, ever the flamboyant writer, began a record of his diagnosis with AIDS and "my passage into nonexistence" in the pages of The New Yorker (see also earlier journal entry, Dying: An Update, annotated in this database).
In this last entry he focuses intensely on the end of consciousness that looms ahead. In spare poetic phrases he describes what he is attempting to grasp-- " . . . this wild darkness, which is not only unknown but which one cannot enter as oneself." He reflects also on memory, medication, creature comforts, family history, the legacy he leaves, and describes with amazement that he feels happy.
Gerald Wilcox is an otolaryngologist who lives with his wife and daughter in a small town in Montana in 1959. Dr. Wilcox has a weakness for women, alcohol, and, lately, morphine (with which he injects himself about once every six weeks). He enjoys writing in his journal almost every evening yet rarely reviews what he has previously written.
Although high on morphine, Dr. Wilcox repays a debt by making a house call late one night to treat a young boy with mastoiditis. On returning home, the doctor decides to bake a coffee cake for his wife at 5 o'clock in the morning while musing on what will happen to his journals after he dies.
Healy focuses on the social and cultural meaning of disease in Britain during the early modern period (roughly the sixteenth and seventeenth centuries). Her chapter on "The Humoral-Paracelsan Body" discusses how the humoral theory of Galen, at this time still dominant in constructing a notion of the human body and its functions, was challenged by a new Paracelsan medicine, with its emphasis on spirit and on experiment instead of book-learning, and by the emergence of syphilis. She also establishes the genre of the "regimen[t]," a text advising how to achieve personal and social order.
Her two chapters on "The Plaguy Body" review the late-medieval and Renaissance history of the plague and argue that the social meaning of the plague as a trope of violence and rebellion shifts over the course of the sixteenth century, from a judgment on Britain's "rich extortioners," careless of the welfare of the poor, to the threat represented by London's unruly urban underclass.
Healy's two chapters on "The Pocky Body" argue that the new disease of syphilis became another dominant metaphor for social disorder because it helped focus anxieties about cultural hypocrisy, corruption, and degeneration, linked to the problems of sin generally and excessive appetite in particular. Her final chapter examines "The Glutted, Unvented Body," another powerful figure of excessive appetite, threatening that the body (and its appetites) would dethrone the head (the site of reason).
Healy demonstrates the importance of debates over the glutted, headless body as a way for British writers to negotiate the problems of a trade imbalance and the tricky terrain of resistance against the intemperate Stuart monarchs, culminating in the execution of Charles I in 1649. In the book as a whole, Healy reads literary and historical texts by authors as diverse as William Bullein, Thomas Dekker, Lucretius, Erasmus, William Shakespeare (Measure for Measure and Pericles), and Milton (Comus).