Showing 181 - 190 of 196 annotations tagged with the keyword "Psycho-social Medicine"
An intern in internal medicine is frustrated by his weekly clinics; he seems unable to understand why most of his patients come to see him, why they seem happy when they leave, and wonders when he is going to have the chance to do "real" medicine, such as ordering tests and making sophisticated diagnoses. One day, he sees an elderly woman who had been worked up over the years for "heart pain" without finding a diagnosis. In the past she had seen other residents for no discernible reasons.
At this visit, the author recognizes that she seems upset, encourages her to talk, realizes that she reminds him of his grandmother. The woman reluctantly admits she has fallen in love with a younger man. The resident is respectful towards her, and recognizes the beautiful woman she had once been. He begins to realize that she has experienced much that he hasn't, and that she has much to teach him about life and about being human.
Mr. Sweet is a neighbor of the narrator, who is initially a little girl summoned with the rest of her siblings whenever Mr. Sweet is threatening to die. The narrator describes how she and her brothers loved Mr. Sweet, despite the fact that he was an indifferent cotton farmer, a frequent drunk, and an inveterate smoker. Somehow the faults of the old man, including his falling-down bouts of drunkenness and his slovenly personal appearance, are not impediments to the devotion he inspires or the affection for him on the part of the narrator and her brothers.
Each time the children are summoned, Mr. Sweet is reputed to be at death's door. "To hell with dying," the narrator's father would say. "These children want Mr. Sweet!" Then the youngsters would leap on the man in bed and begin their miraculous revival. By turns tickling and kissing Mr. Sweet, the neighbor kids manage to revive him time after time. The narrator comes to have faith in her unfailing ability to bring him back to life, and several times the children succeed when the local doctor had given up hope.
Nearly two decades pass, and the narrator is in graduate school when another summons comes. She flies back to the rural South and hastens to the bedside of the old man, now over ninety. But this time, after a brief return to consciousness, Mr. Sweet dies.
The physician author is puzzled about what he can do to help a young woman who comes to him for treatment of her chronic abdominal pain. She has had every test, seen every specialist, and has no clear diagnosis. Only on the third visit, which she has initiated, does he discover that she was sexually assaulted at age 14. He is the only person she has told.
He immediately feels out of his element, and asks her to see a psychiatrist. She refuses, and insists he handle her care. He sets up open-ended visits to allow her time to talk, and looks for help in the medical literature and from a psychiatrist colleague.
Over time, as they explore her feelings and experiences, his patient gains self esteem and transforms herself into a confident, beautiful woman, planning on travel, school, and career. After her last visit with him, he realizes, "I had been chosen to receive a gift of trust, and of all the gifts I had ever received, none seemed as precious."
The narrator, now a grown man, relates the story of his brother Del's troubled life and early death. The real story, however, concerns the narrator himself, as he reflects on his relationship with Del, his father's behavior toward both of them, and on the possibility that he (the narrator) played a role in Del's death.
When the narrator was fourteen, older brother Del--drunk at the time--was struck and killed by a train as he walked along the tracks. But the central event in the story is the narrator's betrayal of Del. Although Del had saved him from falling off a grain elevator roof, the narrator had falsely blamed Del for the near-fatal accident, out of fear of the father's fury, and because "After years of being on the receiving end, it wasn't in my nature to see Del as someone who could be wronged . . . ." [p. 57]
"My father had good reason to believe this lie . . . . " [p. 55] The incident occurred shortly after Del had been released from a juvenile detention facility--detained there for trying to strangle the narrator and threatening their father with a shotgun.
The narrator (later) finds in Del's notebook an essay revealing Del's intention to reform. But with the passage of time after the grain elevator episode, Del reverts to delinquent behavior; a year later he is dead. The narrator never reveals to his father the truth and the family never discusses Del's death.
At times, over the years, as the narrator searches for meaning and closure he believes he can "take all the loose ends of my life and fit them together perfectly . . . where all the details add up . . . ." [p. 68] In the end, however, we are left wondering whether this is possible--for the narrator--or for anyone.
Summary:A Tahitian female lies naked on her belly, terrified by the presence of the spirit of death. Behind her, with an averted phosphorescent eye, the spirit is personified in the form of a harmless old woman dressed in a black shawl. According to island mythology, the title has two meanings: either the young girl is thinking of the ghost, or the ghost is thinking of her. Bold ambiguous shapes and colors (yellow blanket, blue pareu, phosporescent greenish sparks on a violet background) intensify the eerie atmosphere and enigmatic quality of the painting.
Summary:The author, a pediatrician by training who has gradually moved into psycho-oncology and training others in relationship centered care, writes about life in this collection of short vignettes and analyses. She blends stories of her own experiences as patient and as woman with those she has gathered from a long history of patient encounters. There is no temporal sequence, but the work is grouped into thematic segments. The author shares selected, carefully garnered and assessed narratives of life events intended to be spiritually healing to those who are ill or who care for the sick.
Narrated in the style of an "advice" manual, this is the chronicle of a woman who undergoes a hysterectomy and removal of her ovaries. The tone is sardonic. The story begins with the office visit in which the doctor delivers the news and reassures her that she is too "intelligent and sophisticated" to associate her womanhood with her reproductive organs. The physician attempts to persuade the narrator to have her ovaries removed--preventive medicine against the possibility of ovarian cancer--and she finally agrees while groggy from pre-operative anaesthesia. Nothing has prepared her for the emotional and physical lability she experiences after surgery. Even her sexual relationship with her husband is changed.
As she returns for post-operative check-ups, she becomes increasingly conscious of the indignities of the office visit and physical examination: "it strikes [her] that this maximum-efficiency set-up [three cubicles with naked, waiting women] might serve equally well for a brothel and perhaps already does." She feels that she has made a terrible mistake in allowing the doctor to have talked her into anything and that as a male, "there is nothing he can tell you about how you feel, for the simple reason that he does not know."
A hapless country doctor describes with breathless urgency a night-time summons to attend a young patient. Events soon take on a surreal aspect as "unearthly horses" transport him instantaneously to the bedside. The doctor, preoccupied with personal distractions and grievances against those he is employed to care for, fails to find what is revealed to be a vile, fatal wound (symbolizing the Crucifixion?). He is humiliated by the villagers, who are "always expecting the impossible from the doctor," and doomed to an endless return trip, losing everything.
The initial chapter in this novel, Of Mist, and Grass, and Sand (annotated separately), sets the stage for the quest of the young healer/heroine, "Snake," to find a replacement for the snake she had carelessly allowed to come to harm, in the course of caring for a seriously ill child. The remainder of this coming-of-age novel chronicles Snake's journey during her "proving year" (aka/residency training).
Over the course of this year, Snake continues to minister to the sick and encounters, among others, a patient who demands assistance in suicide, a patient who refuses treatment for a gangrenous leg, and a young girl who has been sexually abused (whom Snake eventually adopts and begins to apprentice). There are, as well, myriad lessons in humility, rigidity of thought, and ethnocentrism.
Bette is a poor spinster, a frequent visitor at her cousin Hulot’s household. When the story opens, the Hulot family fortune has been decimated by Baron Hulot’s mistress. He spends all his money on her, leaving his wife, Adeline, and daughter, Hortense, to struggle meagerly along. Hortense, whose dowry is shrinking daily, mindlessly amuses herself by teasing Bette about her "lover", the sculptor, Count Steinbock, who lives above Bette’s apartment. Bette treats the sculptor maternally but loves him with a jealous affection.
Hortense decides she must meet Steinbock and the two fall in love at first sight. Though Steinbock has little money, Adeline agrees to their marriage, but the engagement is kept from Bette. Baron Hulot’s mistress leaves him and he becomes invoved with Madame Marneffe, the wife of one of his employees.
Cousin Bette is bitter towards the Baron and his family because they treat her like a servant. When she hears about Hortense’s engagement to her friend Steinbock, she determines to destroy the whole family. Bette introduces Crevel (whose mistress Hulot once stole) to Madame Marneffe and he becomes a rival lover. Bette also anonymously has Steinbock imprisoned for his unpaid debts.
Meanwhile, Madame Marneffe seduces Steinbock. She then secures her power by telling each of her lovers that he is the father of her unborn child. Hulot reaches the end of the line shortly thereafter, when it is discovered that he has been stealing money from the government. Hulot’s brother dies of grief and Hulot himself goes off to live with a seamstress in the slums.
Madame Marneffe and Crevel also meet miserable ends. Several months later, Adeline discovers her missing husband while on a charity mission. He comes home, but soon seduces the maid. Adeline then dies, her emotional reserves exhausted.