Showing 181 - 190 of 433 annotations tagged with the keyword "Professionalism"
Peter Selwyn spent the first ten years out of medical school at Montefiore Medical Center in the Bronx, caring for HIV-positive patients--mostly intravenous drug users and their families--in the early years of the AIDS crisis. As he worked with dying young men and women and their families, Selwyn returned to his own unexplored pain surrounding the loss of his father, who fell or (more likely) jumped from a 23-story building when Selwyn was a toddler. Mirroring their function in Selwyn’s life, the stories of the five patients who most affected him serve in this book as the threshold to the narrative of how Selwyn investigated, mourned, and commemorated his father’s death, finally revaluing it as central to the person and doctor he became.
Frank Eloff, the novel’s narrator, is a white doctor working at a hospital in the former capital of one of South Africa’s now-defunct independent homelands (rural areas set aside by the apartheid government for black "separate development"). The hospital, in its deserted and decaying city, is understaffed and understocked, and there are hardly any patients. Those who do arrive usually need to be taken elsewhere if they need any significant treatment. The homeland’s former leader, the Brigadier, has returned as a criminal gang leader to loot the place, and a white former army commander, now in the employ of the present government, is trying to capture him.
Frank moved to this place when promised directorship of the hospital (and in flight after his wife left him for his best friend), but the previous director has not left yet, and Frank is in a kind of personal and professional bureaucratic limbo. He has a sexual relationship with a black woman who runs a roadside souvenir stall. It is not quite prostitution, not quite a love affair: she is married, speaks little English, and Frank regularly gives her money.
A new doctor, Laurence Waters, arrives. He is fresh from medical school, sent to the hospital in order to complete the rural community service year required by the government of all new physicians. He and Frank become roommates and begin an uneasy friendship. Laurence is an idealist, planning to make heroic changes, but he misunderstands the complex balance of tolerance, cynicism and patience that characterize survival at the hospital, and his well-intentioned efforts, such as trying to end theft from the hospital and to establish a clinic in a local tribal village, lead to disaster. The novel ends with Frank appointed hospital director at last, and things returning to their depressingly ineffective "normality."
Couser, long interested in autobiography, explores the ethics of representation in biographical writing, and in particular, the ethics of representing vulnerable subjects--for example, the aged or very young, the sick or impaired, or those who are "socially or culturally disadvantaged." He is concerned with representation of people who are intimately connected to the biographer, either as family members, or in some other "trust-based relationship." Couser argues that the relationship between vulnerable subjects and their biographers is analogous to that between patients and their physicians and that therefore principles of bioethics should be applied to such life writing, especially the principles of autonomy, nonmaleficence, and beneficence.
Couser explores life writing and betrayal (Chapter 1), outlines how he will apply the principles of biomedical ethics and ethnographical ethics to life writing (Chapter 2), and applies these principles to examples of collaborative autobiography (Chapter 3). He then critiques in detail Michael Dorris’s memoir about his adopted son, The Broken Cord (Chapter 4); the work of Oliver Sacks (Chapter 6); memoirs of euthanasia (Couser calls these "euthanographies"), Saying Goodbye to Daniel: When Death Is the Best Choice, by Julia Cassutto Rothman; Rescuing Jeffrey, by Richard Galli, and But What If She Wants to Die, by George DeLury (Chapter 7). Finally, in the last chapter, Couser considers how investigation of the human genome might influence the "scripts" of our lives and hence life writing, and also how life writing might be a counter discursive force against genomic essentialism.
In 1848 a member of the Irish gentry named Robert Devereaux is convicted of treason and sentenced to 14 years imprisonment for publishing articles that advocate the violent overthrow of English rule in Ireland. This novel is purportedly based on the journal that Devereaux kept during his years as a prisoner (1848 through 1851).
It begins when he is transported from Ireland to Bermuda, where he spends many months in a prison "hulk." The authorities have to handle him carefully, though, because he is both a gentleman and a symbol of Irish resistance. They do not want to have a martyr on their hands. Thus, when Devereaux develops severe asthma in Bermuda, they send him to Van Diemen's Land (Tasmania), where he is given a "Ticket-of-Leave"; i. e. he is allowed to live as he wishes in the colony, provided he adheres to certain restrictions and agrees not to attempt escape.
Once in Van Diemen's Land, Devereaux is reunited with other prominent political prisoners. He also meets and falls in loves with Katherine, an Irish Catholic woman, far lower in social class. (Devereaux is a member of the land owning Protestant Ascendancy.)
To be close to Katherine, Devereaux buys a hop farm with an English prisoner named Thomas Langford. The lovers intend to escape to New York together, but Katherine is pregnant. She dies shortly after delivering a healthy son. The despondent Devereaux eventually escapes as the journal ends.
The title of this collection of poems recalls the formulaic statement by which a physician introduces a patient's medical problem or chief complaint. For example, "The patient presents with a history of fever, abdominal cramps and diarrhea for the last 24 hours." Or, "The patient presents with a long history of hypertension and diabetes." In this case, though, Dr. White's patients' presentations are poems, rather than chunks of sanitized medical jargon; and, while the patient remains a key character in most of these works, they also present the doctor's story.
Domestic violence, child abuse, and sexual abuse figure prominently in these poems. In "365" (p. 1) a five year old girl presents with "a foul smelling vaginal discharge"; she was a victim of rape. Baby "John Brown" (p. 9) has 47 fractured bones and was "dipped in boiling water" for soiling himself. In "Ironing" (p. 18) a first grade girl has the impression of an iron burned into her thigh. And the two-year-old girl in "Peek" (p. 49) is admitted to the Intensive Care Unit (ICU) with cigarette burns and a liver fracture.
Dr. White also writes of babies left behind by their mothers ("Autumn Angels," p. 3), homeless mothers and children ("Numbers," p. 42), and complex multigenerational family pathology ("Riddle," p. 50). All in all, these stories carry the reader very close to "Looking at the Gates of Hell" (p. 32).
Yet, a still, small voice of calm, maybe even of salvation, can appear in the most unlikely places. In "Belly" (p. 4) the physician lays her face against a baby's belly and "the warm brown skin calms my forehead. / All stiffness melts." In "Maplewood & Greene" (p. 36) she revels in seeing "three little girls on roller skates." And in the Whitmanesque poem called "Oh" (p. 45), she gloriously affirms, "Oh to laughter, oh to sorrow / Oh to a better day, oh tomorrow."
Summary:From a fishing trip the local doctor is summoned to an Indian village to assist a woman in labor. With him are his young son and an older male relative. The physician assesses the situation in the closed, pungent hut and determines that his only option is section--with a pen knife and fishing leader as his instruments, and no anesthesia for the Indian woman. The doctor arrogantly, but only briefly, celebrates his success as a surgeon only to discover that the woman's husband, apparently unable to tolerate his wife's pain and the racism of the white visitors, has silently slit his own throat. The child, who has observed the entire proceedings asks, "Is dying hard, Daddy?"
Dr. Conley became, in 1991, the center of media attention when she publicly declared her reasons for resigning her position as Professor of Neurosurgery at Stanford University: a hostile work environment due to the sexism of the male professor promoted first to acting chair, then chair of her department. This book is her story, but as she notes in the introduction, it is "one of many that could be told by women doctors across the country, about this institution [Stanford University] and many others like it."
Dr. Conley has been a remarkable pioneer in academic medicine: in 1975, she became the first female faculty member at Stanford in any surgical department. She was immediately elected the first female chair of the faculty Senate. She has led an active, innovative research team investigating the immunology of brain tumors. She is the first female tenured professor of neurosurgery in the country.
The book offers behind-the-scenes views of the anatomy lab and medical school, residency and sleep deprivation, the operating room and hospital medicine, and, above all, the political parrying and power struggles in academic medicine, particularly in the dean's office. In a bold move, Conley uses the real names of top administrators and those who had previously been identified in the media--not only concerning her issues, but also those involved with scandals that were unfolding concurrently in other departments.
Because of the circumstances surrounding her resignation and subsequent rescindment of the resignation, she became aware of many instances of sexism, gender discrimination and harassment, not only in academia, but throughout hospital and research environments. Her current position within the University and Veterans Affairs hospital enables her to be a strong voice for women's issues. This book chronicles her personal journey and acknowledges the support of her husband, parents, mentors, and friends along the way.
Veneta Masson’s wonderful collection contains 56 "entries," essays, poems, fragments, and articles about her work as a nurse in an inner-city clinic. Her story is offered not as a neat beginning to end narrative, but as a pastiche of observations that range from commentary on how doctors and nurses approach caregiving, to a poem about Maggie Jones, a patient who changed Masson’s life.
As she follows the growth of the clinic and muses about the professionals and patients who give it life, Masson also talks about nursing: how it was, how it is, and why it’s such an important, and sometimes difficult to define, vocation. Some entries were contributed by Masson’s colleagues, Jim Hall, Teresa Acquaviva, Sharon Baskerville and Katrina Gibbons, but the best are Masson’s own.
This book should be required reading for nursing students, especially entries, "Nurses and Doctors as Healers," A Case for Doctoring Nursing," "Pushing the Outside of the Envelope," "If New Graduates Went to the Community First," "A Good Nurse," "Nursing the Charts," "Tools of the Trade," "Bring Back Big Nurse," "A Ready Answer," "Mindset," "Seven Keys to Nursing," and "Prescriptive Ambivalence." This book, especially for the essays "Nurses and Doctors as Healers," "A Case for Doctoring Nursing," "Prescriptive Ambivalence," and "If New Graduates Went to the Community First," should also be slipped into every medical student’s pocket.
Summary:This film tells the remarkable story of Vivien Thomas (played by Mos Def), an African-American fine carpenter, who found his way into medicine through the back door and changed medical history. Hired when jobs were in short supply to work as a custodian and sometime lab assistant to Dr. Alfred Blalock (Alan Rickman), a research cardiologist, Thomas quickly becomes an irreplaceable research assistant. His keen observations, his skill with the most delicate machinery and, eventually, in performing experimental surgery on animals, make clear that he has both a genius and a calling.
Summary:This novel is narrated by Katie Carr, who very much wants to be a good person. She is a physician and a mother of two, and lives with her petulant husband, David. David is the author of a column in the local newspaper called "Angriest Man in Holloway". As their marriage falls apart, David undergoes a conversion at the hands of GoodNews, a young guru, and ceases to be sarcastic and angry, embarking instead on an effort to improve the world with acts of kindness. Katie is forced to consider what it means to be a good person and how that affects whether to salvage her marriage, how to raise her children and how to be the type of physician she always considered herself to be.