Showing 161 - 170 of 476 annotations tagged with the keyword "Medical Ethics"

Annotated by:
Davis, Cortney

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

A woman is pregnant. She is a nurse married to a physician, Jeff, and they have a young son, Willie. The couple is pregnant with their second child. Long before her due date, the woman--author Susan LaScala--begins experiencing signs of premature labor. Because she is a nurse, because she is married to a doctor who takes call, she doesn't want to over-react or bother her obstetrician unnecessarily. But when vague aches turn into cramps, the author enters, as a patient, the world she had known, until then, only as a caregiver.

It is impossible, in a brief annotation, to describe fully the richness of this memoir. Because the author is a nurse, she brings to the story of the premature birth and survival of her daughter, Sarah, a wonderful double vision: LaScala tells this tale not only as a mother and a patient but also as a clinician able to explain, in simple language, the complex technologies used to sustain the life of her one pound nine ounce baby. The author's rendering of the bells and whistles of neonatal medicine, whether describing the process of intubating a preemie (p. 23) or ultrasounding a baby determined to survive (p. 182-3) are precise and haunting.

Equally compelling (and instructive for caregivers) are the author's candid revelations of how it feels to be a patient. She takes to "grading" the doctors and nurses--an "A" for the staff that lets her see her newborn girl (p. 3), and a "C" for a nurse with "No kind words. No warmth" (p.11). She describes her own bodily sensations in language both lovely and informing: the pushing and tugging she feels during her C-Section is a "quiet violence" (p.21); standing beside her daughter during the ventilator weaning process she feels "a witch's brew of fear and panic mixing and growing inside" (p. 225).

In an introduction, physician Barbara Wolk Stechenberg, describes the "gift" that the author has given by writing this memoir. The author has allowed Dr. Stechenberg, who was part of the team that saved Sarah, "a rare glimpse into two worlds" (p. xii). One was the world of intensive care nurses and how "they truly are the primary caregivers" (p. xii). The other world was that of physicians, who "may feel we are empathic and caring, but we really have no idea of the emotional roller coaster many of our parents are riding" (p. xii).

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The Memory Keeper's Daughter

Edwards, Kim

Last Updated: Mar-27-2008
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Because he can't reach the hospital in a winter snowstorm, Dr. David Henry ends up assisting his own wife in the birth of their twin children at his clinic with the help of his nurse, Caroline. The boy is fine; the girl has Down symdrome. While his wife is as yet unaware, he gives the girl baby to Caroline to take to an institution. Norah, his wife, remains unaware that she give birth to two children, yet is haunted by some sense of loss she can't name. Caroline, unable to leave the baby in an unappealing institutional setting, makes a snap decision to keep her. She leaves town, renewing communication later with the baby's father, and raises her as a single mother until she meets a man who is willing to marry her and love Phoebe as a daughter.

Only after Dr. Henry dies suddenly does his wife discover the existence of her daughter, through photographs sent to him over the years by Caroline, and then a visit from Caroline and Phoebe. Sadly, but with a will to choose life on strange and demanding terms, Norah and her son, Phoebe's brother, choose to enlarge their circle of family to include a loving relationship with Phoebe, clearly her own person, and the woman and man who have cared for her.

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Night Nurse

Macy, Dora

Last Updated: Feb-25-2008
Annotated by:
Garden, Rebecca

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Nurse Lora Hart is working on a private case with two young children who are suffering from malnutrition. They live in a wealthy and chaotic household. Their father is dead, and their mother, who is an alcoholic, and her fortune have fallen into the clutches of her scheming brother-in-law and her thuggish chauffeur, both of whom have been her lovers, among others. The physician caring for the children has been bribed by the children’s uncle, who wants the children to die so that he can marry his sister-in-law and claim her fortune. Nurse Hart secretly defies the physician’s orders and nurses the children back to health. She weathers an attempted rape and a sock on the jaw in the course of her duty at the troubled home. She makes use of her bootlegger boyfriend (this is a Prohibition-era novel) to set up the chauffeur who hit her, and when she learns that the chauffeur has raped her employer’s older daughter, she promises to testify against him in court, even though that results in her being fired from the case and blackballed from hospital work.

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Sicko

Moore, Michael

Last Updated: Jan-08-2008
Annotated by:
Duffin, Jacalyn

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

The movie opens with a shot of a young man stitching up a laceration in his own knee. Another describes how he had to select which of two severed fingers would be re-attached because he could not afford both operations. They are among the millions of Americans without health insurance. But, the narrator says, the movie is not for them; rather it is for the majority of U.S. citizens who do have medical insurance and believe themselves protected.

Through a series of riveting vignettes, for-profit health care is shown to tyrannize the well, ruin the ill, and destroy families. It also erodes the psychological and moral fiber of the people working in the industry. Excursions to England, Canada, France and Cuba are presented in a series of encounters with physicians and patients, none of whom believe that they would be better off in the United States. A French doctor opines that he earns an adequate salary for a good quality of life. Even those seated in a Canadian waiting room profess satisfaction with the care given and understanding about delays. When asked why anyone would accept to pay the expenses of others, an elderly golfer explains patiently that it is what we do for each other in a caring society. Ex-pat Americans gather at a bar to describe their positive experiences with foreign health and maternity care.

Interviews with emotionally distraught people who have worked in the insurance industry reveal the relentless pressure to deny coverage and its reward system that favors those who generate the biggest savings. Special attention is given to Dr. Linda Peeno who testified before Congress in 1996, confessing that she had harmed people for the economic benefit of the insurance industry.

Moore gathers up a group of people whose sorry dilemmas within the U.S. system have left them with serious health problems. He escorts them to Cuba where physicians and nurses are only too pleased to diagnose and treat their illnesses– for free. The movie ends with an exposé of the superior health care given prisoners at Guantanamo and Moore’s stunt at trying to bring the unhappy Americans there for treatment.

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Summary:

In a future society in which biological reproduction is restricted and humanoid robots ("Mechas") are routinely manufactured to supplement the economic and social needs of humans ("Orgas"), Dr. Hobby (William Hurt) creates a prototype child Mecha, David (Haley Joel Osment), who has "neuronal feedback," the ability to love, and "an inner world of metaphor, self-motivated reasoning," imagination, and dreams. David is given to Henry and Monica, a couple whose biological child Martin is incurably ill and cryopreserved, awaiting a future cure.

More specifically, David is created out of Hobby's own loss and given to aid Monica's mourning for Martin, whom she has been unable to "let go" of as dead. It is thus Monica (Frances O'Connor) who must make the decision to perform the "imprint protocol" that will make David love her. After she stops resisting the desire to love a child (of any kind) again and implements the protocol, Martin is unexpectedly cured and comes home.

The ensuing turmoil sends David, accompanied by a robot Teddy bear, out into a nightmare world of adult Mechas, comprised of both Rouge City, where functioning Mechas like Gigolo Joe (Jude Law) do their sex worker jobs and also the fugitive realm where unregistered, discarded Mechas try to find the spare parts they need to rebuild themselves and elude trappers who take them to reactionary "Flesh Fairs" where they are publicly destroyed as an expression of rage against artificial technologies.

Joe and David, both set up and betrayed by humans jealous of their superiority at performing human functions, join together on a quest to make David "real" and return him to Monica. The quest takes them to a partly submerged Manhattan and sends David and Teddy two thousand years into the future to resolve the dystopic narrative.

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Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Collection (Essays)

Summary:

Part of a series, "Letters to a Young . . . [fill in the career]," this collection of essays by pediatrician-author Perri Klass is addressed to her son Orlando during the recent period when he was applying to medical school. The essays follow a chronological sequence, beginning with the decision to apply to medical school, the first two years of medical school, learning how to examine and talk to patients, residency training, physicians as patients, making mistakes, grappling with the most fundamental human issues in medicine, and the mingling of professional work and life.

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Summary:

First published in 1991, and available in reprint edition, this is a compendium of selected artworks and excerpts of diverse medical and literary writings from pre-Hippocratic times to the end of the 20th C. Each chapter integrates selections from medical or scientific treatises, with commentaries written by historians, essays by physicians and writers, and prose and poetry by physicians and by patients. The 235 images in this book include illustrations from medical textbooks and manuscripts, as well as cartoons, sculptures, paintings, prints and sketches. The colour illustrations are stunning and copious, and provide a visual narrative that resonates with each chapter of the book.

The first part of the book, Traditional Medicine, includes chapters on Ancient, Medieval, Renaissance, and Enlightenment medicine. These serves as a preamble for the second part, Modern Medicine, which includes art, medicine and literature from the early 19th century to the end of the 20th century.

The chapter “From the Patient’s Illness to the Doctor’s Disease” illustrates the rise of public health and scientific research with excerpts from works by Edward Jenner, John Collins Warren, René Laënnec, and John Snow, together with experience of epidemic diseases described by writer Heinrich Heine in his essay on “Cholera in Paris”. The chapter on “Non-Western Healing Traditions” includes botanical research by Edward Ayensu, a short story by Lu Hsun and the writing and paintings of George Caitlin on North American Indian healing.

In the patient-focused chapter, “Patient Visions: The Literature of Illness,” are stories of sickness by Thomas DeQuincey, Leo Tolstoy, Giovanni Verga, Katherine Mansfield, André Malraux, and Robert Lowell. The chapter which follows, “Scientific Medicine: the Literature of Cure,” provides the medical counterpoint with personal correspondence by Freud, medical treatises by Wilhelm Roentgen and Louis Pasteur, an essay on surgical training by William Halsted, and an excerpt from George Bernard Shaw's play, Too True to Be Good, in which a microbe takes centre-stage.

There are chapters on “Medicine and Modern War,” which includes personal writing by nurses Florence Nightingale and Emily Parsons, and poems by Walt Whitman, and Emily Dickinson, and “Art of Medicine,” with works by Arthur Conan Doyle, Anne Sexton, James Farrell and W.P. Kinsella.

The final chapter, “The Continuing Quest for Knowledge and Control,” contains no medical treatises but rather ends with personal reflections by the writer Paul Monette on AIDS, and by physician-writers, John Stone, Sherwin B. Nuland, Lewis Thomas, Dannie Abse, and Richard Selzer.

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Annotated by:
Duffin, Jacalyn

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

The exquisite young artist, Angélique (Tautou) sends a rose to her lover, the cardiologist Loic Le Garrec (Le Bihan). She is planning a future with him; the only problem is that he is married. But he has promised to leave his wife. Angélique is little troubled that the couple are expecting a baby and when the pregnancy is lost following an accident, she believes the day will be soon.

Her medical student friend, David, worries that she is being used and is appalled by the accumulation of disappointments and slights that Angélique must endure. She falls apart, neglects herself and the home and exotic plants that she has been watching for friends, but when she hears that Loic has been accused of assault by a female patient, she is utterly disbelieving. The patient is found dead and the doctor falls under suspicion.

Rapid rewind, and the movie begins again with the rose, and by repeating a handful of earlier scenes, retells the same events from the perspective of the doctor. He has no idea who is the sender of the rose, and as the flowers, notes, and gifts accumulate he grows more distracted, even angry, and his wife is suspicious.

It emerges that Angélique and Loic have barely ever spoken to each other and that she actually volunteered for house-sitting next door, in order to be close to him. The accident that caused the miscarriage was Angélique’s attempt to kill his wife by running her down with a motor scooter. The patient who charged the doctor with assault was wrongly mistaken by him for the secret admirer; he struck her out of anger and fear. She presses charges against him and pursues him through the courts until she is murdered by Angélique.

But the doctor knows none of that. When Angélique attempts suicide with gas, he saves her life and she is all the more smitten. Gradually the doctor realizes her real identity and the police link her to the murder. She is sent to a psychiatric hospital.

Years pass. Loic and his wife have two beautiful children. Angélique is finally discharged with reassurance that she will be well as long as she takes her medicine. In the final scene, the caretaker moves a large cupboard to find all the pills that she had been prescribed over four years pasted to the wall in a larger-than-life portrait of Loic.

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Running with Scissors

Burroughs, Augusten

Last Updated: Sep-03-2007
Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

This memoir chronicles the pre-adolescent and adolescent years of the author, the son of an alcoholic, abusive mathematics professor father and a psychotic Anne Sexton-wannabe confessional poet mother. The only family member who does not abuse the boy in any way is estranged--an older brother with Asperger’s syndrome. Meanwhile, the amount of trauma to which young Burroughs is subjected boggles the mind. Just when one thinks it couldn’t get any worse, it does.

Burroughs, who loves bright, shiny, orderly things, also likes doctors--paragons of cleanliness, virtue and wealth. Unfortunately, his mother’s psychiatrist, Dr. Finch, described as a charismatic Santa Claus-look-alike, is unethical, bizarre and squalid. As Mrs. Burroughs becomes more and more dependent on Finch, she allows her son to be adopted into the crazy Finch household.

This family includes wife Agnes, who copes with her husband’s infidelity by sweeping madly; son Jeff, daughters Kate, Anne, Vickie, Hope and Natalie; grandson Poo; and adopted son, Neil Bookman, who is twenty years older than Burroughs and homosexual. When Burroughs is thirteen, and has told Bookman that he, too, is gay, Bookman forces the boy to have oral sex. They become lovers.

The Finches, meanwhile, exhibit their quirks and weird tendencies in multiple ways. "Bible-dipping" is popular to read the future, as is prophesying by examining Dr. Finch’s turds. A patient with agoraphobia, Joranne, lives in one of the rooms--in fact, she has not left the room in two years. Young Burroughs is allowed to smoke and drink. When Burroughs says he doesn’t want to return to school, Dr. Finch facilitates this desire by giving Burroughs alcohol and pills to fake a suicide gesture, then hospitalizes the boy.

Yet Burroughs manages to befriend a couple of the Finch daughters, and to survive his childhood. The book closes with his departure for New York City and with an epilogue outlining various people’s outcomes. Finch lost his license due to insurance fraud.

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Brute

Selzer, Richard

Last Updated: Aug-15-2007
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

In the Emergency Room at 2 AM, a doctor tries to suture a laceration on the forehead of "a huge black man," brought in by the police. The man groans and strains; he won't hold still. Finally, the doctor becomes so angry that he sutures the patient's earlobes to the mattress. Not only that, he leans over the man's face and grins: "It is the cruelest grin of my life." Then he sutures the man's wound.

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