Showing 161 - 170 of 251 annotations tagged with the keyword "Medical Education"
The surgeon-narrator and his team of assistants (the anesthesiologist, scrub nurse, circulating nurse, surgical resident, and medical student) perform a difficult operation during the night. The patient has an infiltrating cancer of the stomach (linitis plastica) that has eroded his aorta. Because of uncontrollable bleeding, the operation (an exploratory laparotomy with attempted repair of a malignant aorto-gastric fistula) is as doomed as the patient himself.
The surgeon soon comprehends the hopelessness of the procedure as well as the patient's terminal condition. He turns off the oxygen from the gas tank and stops the patient's blood transfusion. Minutes later, the man dies. Blood is all over everything. The doctor must now deliver the bad news to the man's family. He has the medical student tag along.
Members of the patient's family are upset and some are even out of control so he dispenses tranquilizers to them. The surgeon returns to the operating room (OR) and even now finds blood everywhere. The OR team is still working. The doctor showers and then goes back to the OR once more. The room is now dark and empty but clean. The surgeon imagines the dead man's body with a row of abdominal stitches that he likens to hieroglyphics. The unsuccessful operation and the surgeon's actions are thus both concealed and unforgettable.
Physician and poet Rafael Campo sometimes gives poems to his patients, tucking them in with educational materials and prescriptions. He knows that poetry can be therapeutic for both patient and caregiver, and in this beautifully organized and executed book he tells readers why and how poetry can enhance healing.
The chapters (in which Campo ponders questions such as: Is poetry necessary for survival? How does poetry locate us inside the experience of illness? Why is poetry therapeutic?) follow the arc of illness itself. In Chapter 4, "Inklings," Campo discusses how not-yet-diagnosed symptoms of sickness may be revealed in poetry, the patient "divining" signs of illness "from the clues discernible in a sentient relationship to the world around us" (p. 52).
In following chapters ("Diagnosis," "Treatment," "Side Effects," and "End of Life"), he expertly unfolds, through brilliant poem analysis, how "At every station of the disease experience, poetry has suggested an ulterior discourse that, as it accumulates, forms a composite picture of a humane idea of wellness" (p. 127). In other chapters ("Daniel," "Clara," "Sunny," "Eduardo," and "Mrs. Twomey") he discusses how poetry has changed and informed his clinical and personal interactions with patients.
Fully aware that poetry is not a "cure" for illness and that relationships between patients and caregivers are not always ideally sympathetic, Campo demonstrates how, nonetheless, poetry can be a valid healing modality. In the "Afterword," he urges readers to imagine poetry "as a metaphor itself for the process of healing" and "to experience it through the stories and voices of real people who have themselves called upon it as they faced illness" (p. 188), and he states his wish to see "non-poet physicians use this book with their own patients and medical trainees" (p. 190). An excellent "Further Reading" appendix provides wide-ranging selections for further study.
The House of God is a chronicle of Roy Basch's internship year at a prestigious Boston teaching hospital, also known as The House of God but clearly modeled after the Harvard-affiliated Beth Israel Hospital. Cycling through various medical disciplines, Roy and his peers learn medicine from the eccentric, irreverent, yet oddly compassionate Fat Man, whose 13 Laws of the House of God cynically summarize the harrowing and often demeaning hospital practices and rituals reflected in both the doctor-patient relationship and in the residency experience itself.
Author Horace Davenport is a retired professor of physiology who had a distinguished career in medical science. This book reflects his more recent interest in the history of medicine and physiology in the 19th and 20th centuries. The best summary of this transcription with commentary resides in the author's own introductory paragraph, paraphrased here: From 1899 to 1900 fourth year medical students at the University of Michigan doing their medicine and surgery rotations attended a diagnostic clinic twice a week with George Dock, A.M., M.D., professor of theory and practice of clinical medicine. Dr. Dock had a secretary make a shorthand record of everything that was said at these clinics by Dock himself, the patients, and the students.
The clinics and recording of the interactions continued until the summer of 1908 when Dr. Dock left Michigan for a position at Tulane. The typed transcripts of these sessions fill 6,800 pages. This book is Davenport's distillation and, on occasion, clarification of these documents. In these transcriptions resides not only a view of the practice of academic medicine at the turn of the 20th century, but also a glimpse at one clinician's interpretation of clinical material in his own time.
The time is 1954 and the place Boston. Dan Lassiter is a first year medical student back from Inchon and the Korean War, taking--and in danger of failing--anatomy when he becomes obsessed with his cadaver, a young and very well proportioned man he thinks must have been a boxer. As he tries to pass anatomy under the withering and authoritarian attention of Dr. Nathan Snider, a stern anatomist who worships at the altar of Vesalius, Dan discovers that his cadaver is a very physically fit young man, whose death fascinates him and about whom his professor will not yield any information. Using his newspaper connections with one of several women he's dating, Dan discovers that the cadaver Dr. Snider refused to identify was Rick Ferrar, a fearless boxer who was fast friends with Lemuel Harper, an African-American and also, like Dan, a veteran of the Korean War.
The remainder of the book resolves the familial baggage Dan is carrying from his parents' death and then his brother's; his quest for the character and mode of death of Rick Ferrar; the intertwining of his and Rick's personalities, girlfriend, and destinies; and his medical school career, which at times seems more a hobby than a serious pursuit. By novel's end all the subplots are resolved and Dan, attending a funeral for the class's cadavers, volunteers to work with Dr. Snider in the anatomy lab to improve his mediocre knowledge of anatomy.
Summary:As a medical student Stone moves ("in our own tense tendons") into a new understanding of the body, in which knowledge of names ("the word") gives power over the mysteries that lie under the skin. "Ribs spring like gates." Within the gates they [students] find the secret cause of death: an aortic aneurysm. But the aneurysm isn't just a fact; it tells a human story, a story of an "old sin-- / the silent lust / that had buried itself . . . ." Thus, the cadaver speaks.
Dr. Flaherty, a practicing neurologist, sets out to explore the act of writing and, more broadly, creativity, in the context of both neuroscience and emotion. She begins by describing several brain conditions that seem to enhance the need to write, even to the extent of obsessive hypergraphia. Next she turns to the opposite state, writer's block, looking at both psychological and neuroscientific perspectives.
Using some of the recent studies of the relationships between certain brain centers and language related phenomena, Flaherty further clarifies some of the cognitive bases for creating literature. Finally, the study turns specifically to the temporal lobe as the possible organic site of the perceived voice of the muse in religious and creative inspiration.
This is a collection of 23 stories, five of which take the form of "letters" in which an older physician (not surprisingly, a surgeon) gives advice to an imaginary young surgeon. However, every one of the stories "fits" as a tale that might be told in such a letter--assuming the author was a wise and gifted writer, in addition to being a surgeon.
The book begins with the gift of a physical diagnosis textbook on the occasion of the young doctor's graduation ("Textbook") and ends with a reflection on "your first autopsy" ("Remains"). Among the other stories are Imelda (see annotation), Brute (see annotation), Toenails (see annotation), Mercy (see annotation), "A Pint of Blood," "Witness," "The Virgin and the Petri Dish," and "Impostor."
The new interns, Roy Basch (Tim Matheson), Chuck (Howard Rollins, Jr.) and Wayne Potts (Michael Sacks), begin their year of internal medicine training in a busy city hospital under construction. After initial introductions led by the vague staff man and vapid chief resident, they become the specific charges of the cynical resident doctor "Fats" (Charles Haid). Fats teaches them attitude and language: how to "buff" (improve) and "turf" (transfer) "gomers" (Get Out of My Emergency Room)--the words used to describe management of incurable, hateful patients who "never die," regardless of the abuse the clumsy housestaff might inflict. But Fats has heart.
Soon, they fall under the command of the militaristic and lonely woman resident, Jo Miller (Lisa Pelikan), who cannot bring herself to withhold treatment, even at a patient's request. She blames underlings for the failings of medicine and nature, as well as herself.
Wayne throws himself from the hospital roof because of a misplaced sense of guilt over a patient's demise. Roy falls in love with the nurse, Molly (Kathryn Dowling), but nearly loses her as he begins to emulate Jo's cold, calculating style. He is "rescued" in the nick of time by his friends, Fats, and the death of a physician patient (Ossie Davis) whom he admires. With recovered equanimity and renewed anger over the suicide of his fellow intern, Roy refuses to go on with his residency.
The author, Samuel Shem, opens these reflections by saying that he was a writer before he was a doctor. His early answers to questions about healing came from stories he read. "Life as it should be in addition to life as it is" became the "motor" of his writing. He loved stories that he heard from patients and the "few humane doctors" he met and decided he would be able to understand people better by writing about experiences with them.
Shem's experience as an intern spawned The House of God (see this database) and he sees writing about his training as an example of the use of resistance when he saw "something unjust, cruel, militaristic or simply not right." He recommends the following to resist the inhumanities in medicine: (1) Learn our trade in the world, (2) Beware of isolation, (3) Speak up, (4) Resist self-centeredness. He says that the healing essence of narrative is in "we," meaning the patient and the physician.