Showing 171 - 180 of 478 annotations tagged with the keyword "Art of Medicine"

Annotated by:
Kohn, Martin

Primary Category: Literature / Fiction

Genre: Collection (Short Stories)

Summary:

Jay Baruch offers readers a series of multi-layered stories focusing on caregivers, both professionals (doctors and nurses primarily) and family members, and those they are trying to care for. The setting for a number of the stories (and therefore a number of the characters) is from the working class or underclass. Another group of stories is written from the perspective of medical students, residents or physicians early in their training. In all the stories, the characters' lives are close and full of conflict. The language they use to express themselves is raw and direct. There are no simple solutions to their problems. Yet struggle on do these characters, testing the limits of their compassion and abilities to deliver care at least competently.

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Summary:

In this collection, twenty-two medical students and young physicians across the United States eloquently recount the process of medical education for those who do not believe they fit standard measures of student demographics. The editors, Takakuwa, an emergency medicine resident physician; Rubashkin, a medical student; and Herzig, who holds a doctorate in health psychology, group the essays into three sections: Life and Family Histories, Shifting Identities, and Confronted.

Each section is prefaced by an essay explicating the essay selection process, the history of medical school admissions policies and requirements, the basic progression of medical education and the reasons for this collection, such as "putting a human face" (p. xx) on the changing characteristics of admitted medical students: "With their diversity and through their self-reflections, we hope that these students will bring new gifts and insights to the practice of medicine and that they might one day play an important role in transforming American medical education into a fairer and more responsive system." (p. 141)

Additionally, a foreword by former Surgeon General Joycelyn Elders outlines her experience as a black woman entering medical school in 1956, including eating in the segregated cafeteria. The book concludes with recommendations for further reading and improvements to the medical education process as well as with brief biographies of the contributors and editors.

The range of essays is impressive: diversity itself is given a new meaning by the variety of narrative voices in this volume. Contributors include people from impoverished backgrounds, both immigrant (Vietnamese, Mexican) and not. One student, marginalized by his academic difficulties, began a homeless existence during his first clinical year. Others were made to feel different because of being African or Native American.

In two essays, mothers defy labels placed on them (pregnant black teen; lesbian) and describe the trials and triumphs of their situations. Students write of being subjected to ridicule, ignorance and prejudice due to their gender, interest in complementary medicine, political and advocacy views, or religious beliefs. Due to pressures to conform, even students from what might be considered more mainstream in American culture (e.g., growing up in a small town, or being Christian) can experience the effects of being "different" when in medical school.

A number of essays communicate the difficulties of illness, disability and bodily differences. Issues include recovered alcoholism (rather tellingly, this is the only essay that is anonymous), obsessive compulsive disorder, sickle cell anemia, Tourette Disorder, attention deficit hyperactivity disorder, chronic pain, and obesity. The authors balance their narratives of hardship with insights into how their struggles improve their opportunities for empathy, perspective and fulfillment as physicians.

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Bedside Manners

Watts, H. David

Last Updated: May-25-2007
Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Collection (Essays)

Summary:

The subtitle to this collection of insightful and compassionate essays by gastroenterologist David Watts is: "One Doctor's Reflections on the Oddly Intimate Encounters Between Patient and Healer." Watts provides 48 narratives, most of which concern his patients and are written in the first person. In the preface Watts states "The stories in this book are true" (xv), that he has received permission from his patients, and that he has "disguise[d]" his patients to respect their right to privacy.

The stories cover a range of settings, from Watts's home and locations in the San Francisco Bay area, to the clinic and hospital. They also cover a range of his experience from medical school ("Sylvester" and "Love is Just a Four-letter Word") to his current position as a practitioner and an attending physician at a teaching hospital.

Stories in which Watts clearly situates himself with the patient and details the encounter are most compelling. For example, in the opening essay, "White Rabbits" and later, in "Flu Shot," Watts allows the reader to discover that patience and listening are required to in order for the patient to expose why he or she is truly there. In that space, Watts becomes present for his patient, and one learns that what may initially appear tangential is central to the patient's concern.

Watts writes of some very difficult patients and families, such as a woman who stalks him ("The Stalker's Bridegroom"), a woman who obsesses over caring for her elderly mother ("Home Remedy"), and a woman who demands narcotics ("The Third Satisfaction"). In one of the longer pieces, "Codger," Watts describes an irascible, elderly Jewish patient who skewers just about anyone with his critiques, including Watts's young son, and yet who later exposes his vulnerability by unfolding the tale of his World War II service and discovery of a Nazi death camp. It is because Watts spends time with the Codger and recognizes that the doctor-patient relationship is above all a human relationship that the doctor receives the gift of the story: this terrible experience which informed the rest of the Codger's life.

A few of the vignettes explore the therapeutic potential of poetry. For instance, in "Annie's Antidote" a piano teacher, fearful of endoscopy, asks Watts to recite one of his poems. The poem concerns the tender relationship between Watts and his son and is a metaphor for Watts's patient encounters as well: "for this is one of those moments / that turns suddenly towards you, opening / as it turns, as if we paused / on the edge of a heartbeat. . . " The poem works, the moment opens, and the woman has her endoscopy.

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Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Nonfiction

Genre: Biography

Summary:

Born in Vienna, Alma Rosé (1906-1944) was a gifted violinist with an illustrious concert career. Her mother was the sister of composer, Gustav Mahler, and her famous father, Arnold, conducted orchestras. All the family members were non-observant Jews. Alma was talented, beautiful, audacious, and arrogant. After an unhappy early marriage to Czech violinist Vása Príhoda, she established a remarkable orchestra for women that toured Europe.

As the German Third Reich consolidated its power, her only brother, Alfred, fled to the USA. She managed to bring their widowed father to England, but displaced musicians crowded London making work difficult to find. Alma left her father and returned to the continent, living quietly as a boarder in Holland and giving house concerts when and where she could. She took lovers.

Despite the urging of her family and friends, she kept deferring a return to safety in England. In early 1943, she was arrested and transported to Drancy near Paris, thence to Auschwitz six months later. Initially sent to a barrack for sterilization research, she revealed her musical brilliance and was removed to marginally better accommodations and allowed to assemble an orchestra of women players.

The hungry musicians were granted precarious privileges, but Alma became obsessed with their progress and insisted on a grueling schedule of rehearsal and perfection. Some said that she believed that survival depended on the quality of their playing; others recognized that the music, like a drug, took her out of the horror of her surroundings.

In April 1944, she died suddenly of an acute illness thought to have been caused by accidental food poisoning. In a bizarre and possibly unique act of veneration for Auschwitz, her body was laid "in state" before it was burned. Most members of her camp orchestra survived the war.

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Summary:

This remarkable collection of short writings, introduced by renowned poet Naomi Shihab Nye, who visited the Sutterwriters (of Sutter Hospital in Sacramento, California) to offer a workshop, provides a broad, compassionate, imaginative window into the life inside and around an urban hospital. Patients, staff, and all interested in healing through writing are invited to come and participate-with an accent on the latter: no one is invited who isn't willing to write.

Chip Spann, the editor, came to Sutter Hospital with a Ph.D. in English, and has the privilege of coordinating this fluid community of writers as part of his work as a staffmember. His conviction, voiced in an engaging introduction, is that literature is a powerful instrument of healing--both the literature we read and the literature we create--and that the experience of literature belongs in community. The individual pieces are accompanied by photographs and short bios of contributors.

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Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

A group of eight women gather for a joint consultation with Dr. Kailey Madrona who is a devotée and colleague of the research endocrinologist, Dr. Jerilynn Prior, a professor at University of British Columbia in Vancouver. Madrona explains that she has arranged for the unorthodox group encounter because she will be leaving practice to pursue graduate studies in medical history.

Dr. Madrona leads an open-ended discussion on the physiological changes associated with perimenopause. Following the controversial research of Prior, she emphasizes that the symptoms are owing to the unbalanced rise in estrogen levels during perimenopause—a period leading up to the cessation of menstruation and continuing for twelve months after the last flow.

Some women patients are skeptical, because they have been placed on estrogen ‘replacement” medication, or they have read that their symptoms are owing to the waning of estrogen. The doctor describes the results of various trials about supplmentary estrogen, including the 2002 Journal of the American Medical Association report. She invites them to keep detailed diaries of their cycles and symptoms.

One by one the women return for private consultation, physical examination, discussion and another follow up visit. Although they have reached roughly the same physiological moment in life, they are a diverse group with different symptoms and needs. Darlene, an angry nurse, is suspicious and non-compliant. Beverley, an Asian immigrant is still hoping to become pregnant. A lesbian wishes to control her moods and hot flashes. A very hard-working waitress needs to understand her strange lack of energy. A wiry, lean athelete wants to improve her performance and is irritated by the inexplicable alterations in her abilities. Others are plagued by sweats, nausea, or migraines. They all are confused about sex.

Dr. Madrona listens to them carefully, examines them with special attention to their breasts, not their genitalia, and recommends treatment with progesterone for everyone. She also urges weight gain for most and readily volunteers personal information about her own perimenopause. All but the nurse eventually comply and are relieved of their symptoms. At the end of a year they meet for a pot-luck dinner to celebrate their recovered health and thank their doctor. Beverley is pregrant.

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Summary:

Tracy Kidder met Paul Farmer in 1994 when the former was writing an article about Haiti. They next met again in 1999 but it was only when Kidder expressed an interest in Farmer and his oeuvre that Farmer emailed him back, writing "To see my oeuvre you have to come to Haiti" (17). Kidder did just that, following the peripatetic workaholic Farmer to Peru, Russia, Boston, and wherever Farmer flew, which is anywhere there is poverty and disease, especially infectious disease.

In Mountains Beyond Mountains (MBM), Kidder chronicles Farmer’s childhood, medical school years (almost a correspondence course with Farmer’s frequent trips to Haiti), his founding of Partners in Health (PIH) and the construction of the medical center in Cange, Haiti, where "Partners in Health" becomes Zanmi Lasante in Creole.

The story of Farmer’s crusade for a more rational anti-tuberculosis regimen for resistant TB; his political struggles to wrestle with drug manufacturers to lower the price of these and medicines for HIV; his charismatic establishment of a larger and larger cadre, then foundation of co-workers; the story of Jim Kim, a fellow Harvard infectious disease specialist; Farmer’s marathon house calls on foot in Haiti; endless global trips punctuated by massive email consultations from all over the world; and gift-buying in airports for family, friends and patients--these are fascinating reading. In the end one is as amazed and puzzled by the whirlwind that is Paul Farmer--surely a future Nobel Peace Prize laureate like Mother Teresa--as Tracy Kidder was and grateful to have the opportunity to read about it by such an intelligent writer.

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Fix

Margolis, Leslie

Last Updated: May-21-2007
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel for Young Adults

Summary:

Cameron, 18, and her sister Allie, 15, have inherited their father’s large nose. Living in Los Angeles, at the epicenter of the entertainment industry, they are familiar with the social currencies of money and beauty. Their mother, a former film actress, auditioning again after years at home, is exceptionally beautiful. Cameron’s “nose job”—the rhinoplastic surgery her parents arranged for her when she entered high school—has changed her life; it is debatable whether altogether for the better. She is now popular and accepted, but also, after a history of rejection and peers’ mockery, fixated on the kinds of beauty that bring social acceptance. Her interest in photography dovetails with this fascination.

At just the time her parents decide to arrange for a similar “nose job” for Allie, who doesn’t want it, and would rather spend the summer at soccer camp, Cameron decides to use her savings, and her new legal freedom as an 18-year-old, to have breast augmentation. Her parents and most of her friends oppose it, her boyfriend most strenuously, who can’t understand why she would take the risks entailed to do something so clearly unnecessary. As the girls learn, their mother has, at the same time, decided to have a face-lift as a return-to-career move.

Both Cameron and her mother go through the surgery—Cameron at the cost of considerable pain in recovery and aware of the long-term risks and costs. Allie, on the other hand, after coming to know an aging actress who was once a beauty, makes an eleventh-hour decision to refuse surgery and with it, the impossible standards of beauty that seem to her to entrap so many like her sister.

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The Vanishing Line

Grainger-Monsen, Maren

Last Updated: May-19-2007
Annotated by:
Shafer, Audrey

Primary Category: Performing Arts / Film, TV, Video

Genre: Video

Summary:

Maren Grainger-Monsen, a filmmaker and emergency medicine physician, chronicles her personal journey towards understanding death and dying as she explores the stories of those near death. The film uses a metaphor of the thread of life, and the three Greek Fates who control life (spinning, measuring and cutting this thread), to interweave Monsen's journey with the lives--and deaths--she encounters.

The film begins with her recollection of two experiences during her emergency medicine training: the first time she is paged to pronounce someone dead and a "crisis point"--resuscitating a patient, brought to the emergency room, who had specifically requested no resuscitation. The remainder of the film focuses on Jim Brigham, a social worker for a hospice program, whom Monsen joins for his home hospice visits and who relates the touching and memorable story of his wife's life and death.

Some of the patients Jim visits are Tex, a man dying of heart failure who had experienced a difficult, scary night; Sean, who has Lou Gehrig's disease and who needs help with paperwork and family concerns; and Anna Marie, who has lymphoma and is taken via ambulance to the hospital for comfort measures. Monsen notes how comfortable Jim is discussing death issues and how compassionate and caring he is with a recent widow in the midst of her "grief work." By contrast, Monsen admits to feelings of helplessness, vulnerability, even terror. She wishes her medical education had not been so devoid of teaching regarding death and dying.

Monsen comments on the wavering line between life and death, and whether the "medical machine" prolongs life or death. She visits a young boy left with severe brain damage following a near-drowning incident and "successful" resuscitation 5 years previously. The boy requires constant care, but his father notes that his son is "doing pretty good."

By the end of the film, Monsen has learned "how to sit with someone . . . while death walks into the room." Death no longer equates with failure. She concludes with her overvoice, "I wonder what it will be like to be a doctor who doesn't see death as the enemy."

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The Quack

Dou, Geritt

Last Updated: May-17-2007
Annotated by:
Clark, Stephanie Brown

Primary Category: Visual Arts / Painting/Drawing

Genre: Oil on canvas

Summary:

Among the "scenes from everyday life" which constitute so-called "genre" painting in 17th Century Dutch art, the profession of medicine was often lampooned. In Gerritt Dou’s painting, the doctor is depicted as a deceiving charlatan, marketing his products with impressive but unsubstantiated claims about their effectiveness. In Dou’s hometown of Leiden, with the Blauwpoort (Blue Gatehouse) in the background left, the quack has set up shop outside the studio of a painter. [At the Web Gallery of Art on-line site, select "D" from the Artist Index, scroll down for Dou, select "Page 2".)

The artist gazes out of his window, holding the tools of his trade, a pallet and brushes. Directly beside him the quack stands under a Chinese umbrella, with stopper in his hand, and presents the patent medicine in a large glass vial to his audience. On his table is a document with a large and authoritative red seal, indicating his credentials and bolstering his credibility. On one side is a barber- surgeon’s basin, on the other is a monkey.

A crowd has gathered around, including a huntsman with a dead rabbit suspended on his rifle, a man with vegetables in a cart, and a woman with a pancake griddle and batter in a large bowl in the right foreground; she is cleaning and diapering a child. In the right foreground a woman gapes at the doctor and his medicine, unaware that her pocket is being picked. In front of her sprawls a child who holds a bread crust to bait and capture a small bird. In the left foreground is a tall, twisted and dead tree; across from it at the corner of the artist’s studio is a living tree lush with foliage.

While Nicolas Tulp (see Rembrandt’s "The Anatomy Lesson of Nicolaes Tulp") enjoyed a reputation as the "Vesalius of the North," this painting is more typical of the prevailing popular depictions of the doctor, not just in the Netherlands but elsewhere in Europe and equally subject to mockery and suspicion. At this time medical care was provided by local physicians, but also by traveling barber-surgeons whose skills and knowledge were dubious.

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