Showing 191 - 200 of 510 annotations tagged with the keyword "Hospitalization"

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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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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Life As I Knew It

Hacker, Randi

Last Updated: May-25-2007
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel for Young Adults

Summary:

Sixteen-year-old Angelina Rossini tells the story of the year her father died. A lively, opinionated, attractive sixty-nine-year-old Italian happily married to a forty-two-year-old English woman, he has hardly been an inconspicuous presence in the small town of Blodgett, Vermont with a population of 854. Angelina, the only child of this second marriage, loves her father dearly, though she rolls her eyes at his eccentricities, and knows herself to be fortunate in both parents, though they're older, and her mother somewhat less expressive, than she would choose. Her best friend, Jax, belongs to a very different family, large, blue-collar, partly French Canadian. Though she and Jax have been friends since kindergarten, and though she has known for some time that he is gay, her love for him sometimes spills over into desire. They talk about this, as they do about everything else, though this subject is a little tenderer than most. When a girl who has been aggressive and unfriendly suddenly reveals her own same-sex desires, Angelina is able to handle her awkward revelation with compassion.

When Angelina's father has a stroke, all the rhythms of family life are disrupted. Her half sister, whom she's never liked much, comes for an extended visit. Her mother is preoccupied, first at the hospital, then with home care. And she herself has to learn aspects of caregiving for a partly paralyzed father who has lost his speech. The process is, of course, emotionally complex, sometimes comical, often heartbreaking. But when she speaks at his funeral, after a heart attack takes his life, it is with a widened appreciation of the kind of man he was, and of what value his life had even in the months he was severely incapacitated. After his death, she explores, in a few final chapters, the ambiguities of grief, and the process of forging a new relationship with her mother, who has lost her own best friend and companion.

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Summary:

This film combines light-hearted scenarios of poor to absurd communications with patients on issues of death and dying, with measured advice from physicians expert in such communications. In addition, a scenario of a woman physician and her patient with advanced breast cancer models a positive example for doctor-patient communication on issues of planning for death and choosing life-sustaining options.

The film opens with a madcap grim reaper dancing and singing a message from Dr. Fletcher to a patient at home: you have six months to a year to live. These same actors morph through a series of roles sprinkled through the film: a physician using medical jargon with a non-comprehending patient, an ad for a phrase book to "speak like a patient," another doctor-patient scene with the physician now graphically describing cardiopulmonary resuscitation using wild gestures, and a waiter advising a patient/patron on item selection from the Terminal Cafée menu (no vegetables!).

The experts discussing death and dying are: Michael Clement, MD; Lisa Capaldini, MD; Doriane Miller, MD; Bernard Lo, MD and Kate Christensen, MD. They offer sage advice on communication, avoidance of medical terminology (even words like 'diagnosis' and 'procedure' can be misunderstood), pain management, informing patients of anticipated poor outcome with cardiopulmonary resuscitation, asking patients what is important to them, goals of treatment, who should make medical decisions, and the setting of such discussions. Cultural sensitivity is briefly discussed, with an emphasis on respecting the patient's individuality rather than assuming a fit within cultural expectations.

The exemplary scenario demonstrates positive qualities and key points: both physician and patient are seated and dressed; the physician asks the patient if she wants another person present for the ensuing discussion and also inquires as to the quality of discussions with the spouse, whom the patient designates as the one to potentially make medical decisions; the specific fears and desires of the patient are sought; and the physician recaps what the patient says and asks her if the summary is correct. In addition, resuscitation is explained in detail. The visit concludes with the doctor encouraging future discussions and allowing decision changes.

The film ends with the finale to the opening scene. The patient slams the door on the grim reaper, who, beset by dogs, returns to Dr. Fletcher and advises the doctor to talk to his patients himself.

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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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Fieldwork

Hicok, Bob

Last Updated: May-18-2007
Annotated by:
Shafer, Audrey

Primary Category: Literature / Poetry

Genre: Poem

Summary:

Hicok begins the poem with a statement and jocular rhetorical question that set the tone and pace: "There are two kinds of people and five hundred / seventy-one thousand, three hundred / ninety-six species of beetle but who's / counting?" Immediately we wonder what are the two types of people and who would take the trouble to write out a species count while also joking about it.

The engagement with the poem continues as we learn about the narrator's platonic friend, an entomologist, freshly returned from the Amazon with a bottled beetle and a raging fever. The narrator, alarmed at her delusional state, rushes her to the hospital ("driving / in a way that proved you can be / in two places at the same time") and good medical care. After several days she has regained enough strength to say one word--jar--which refers to the jar containing her beetle specimen. The narrator restores the jar to her, she recovers and returns to the life she loves, a life in the treetops of the Amazon jungle.

Through the course of the poem, the poet plays with all manner of philosophy and religion. The beetle's body is likened to Michelangelo's image of the finger of God reaching towards Adam. The poet plays with numbers as well, rearranging the numbers of types of people and beetles (and throwing in the number of "delicatessens where you can get a fried- / tuna sandwich on waffles"). This lightness is a disarming way to shed light on the heart of the poem--the narrator's deep caring for the scientist and the scientist's deep caring for her work of discovery.

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Annotated by:
Bertman, Sandra

Primary Category: Performing Arts / Film, TV, Video

Genre: Video

Summary:

West coast dancer John Henry made his life the subject of his final performance. Choreographer Bromberg and film maker Rosenberg collaborate with Henry in the creation of a work for the theatre based on his desire to leave an autobiographic legacy. Filmed during the last few years of Henry's life with HIV/AIDS, the documentary examines the image of self as one individual prepares to separate from body and personhood, and continues after his death.

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Dax's Case

Burton, Keith

Last Updated: May-17-2007
Annotated by:
Jones, Therese

Primary Category: Performing Arts / Film, TV, Video

Genre: Video

Summary:

In the fall of 1979, Keith Burton, a free-lance journalist, saw the videotape 0105 in a bioethics seminar at Southern Methodist University (see annotation in this database). The structural centerpiece of this 1974 documentary is the interview of a burn patient, Donald "Dax" Cowart, by psychiatrist Dr. Robert B. White at the University of Texas Medical Branch in Galveston. Dr. White had been called in to determine the patient’s competency because of his persistent requests to end the painful treatments, to go home, and to die.

Similar to most viewers of Please Let Me Die, Burton was intrigued by the unanswered questions and the uncertain outcome of the case and ultimately contacted Dax Cowart and his mother, Ada Cowart. Burton invited their collaboration on a follow-up videotape to Please Let Me Die, with the intention of providing "a living record of this man’s struggle for release from pain and despair." [see Keith Burton, "A Chronicle: Dax’s Case As It Happened." In Dax’s Case: Essays In Medical Ethics And Human Meaning, ed. Lonnie D. Kliever. (Dallas: Southern Methodist University Press) 1989: 1].

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The Killing Sea

Lewis, Richard

Last Updated: May-13-2007
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel for Young Adults

Summary:

Sarah and Peter Bedford are sailing with their parents off the coast of Indonesia when the tsunami strikes. As they attempt to escape, their father breaks his leg. Their mother insists the children run ahead, so they do, up the hills into the jungle. Sarah later finds her mother, dead, on the beach, but not her father. Peter is soon running a fever and Sarah embarks on an arduous overland journey to try to get him help. At the same time Ruslan, an Indonesian boy, has taken his own escape route out of his village, and is looking for his father, along with many who are searching for missing relatives. Ruslan and Sarah recognize one another when their paths cross, as he had waited on her family on an earlier stop in his village. Together, with a few other refugees, they make their way to another village where Peter may be able to receive help in a makeshift hospital. Ruslan is threatened by an additional danger, since his family are partisans in a local conflict, and he is suspected of activity on behalf of the rebels.

At the hospital, lack of personnel and supplies throws Peter's survival into doubt, as well as the prospect of finding the children's father. Eventually Ruslan finds his own father, and Sarah and Peter are rescued by the military and taken to a base where more adequate care may be provided. Once there, Sarah finds herself swarmed by journalists, but realizes that the international attention their own case has incited is lopsided, given the many locals whose stories of loss and suffering are not being told. The story ends with the fates of Peter and their father unresolved; clearly part of the story is that no "end" is in sight, and that it will be a long, long time before anything that looks like "normality" will be restored.

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Annotated by:
Garden, Rebecca

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

David Lynch’s The Elephant Man is based on the life of Joseph Merrick (1862-1890), a man who we first encounter in the film as “The Elephant Man” of a freak show, whose physical differences are so frightening to the authorities that the exhibit is closed. An ambitious young surgeon, Frederick Treves (Anthony Hopkins), seeks out Merrick (John Hurt) as a subject for a presentation to the Pathological Society and, taken by Merrick’s intelligence and amiability, arranges for Merrick to have a permanent home on the premises of London Hospital. The film portrays Treves as rescuing Merrick from a wretched existence in the squalid wharf district, where he is beaten savagely and otherwise abused by his sideshow manager, Bytes.

Treves provides Merrick with modest bourgeois comfort in the form of private rooms on the hospital premises. When the London Times publishes a letter from the hospital director describing Merrick’s disfigurement as terrifying and requiring isolation, first a famous actress, then most of London high society seek out Merrick, some to befriend him, others to indulge in spectatorship or the fashion of the day. A hospital porter who has access to Merrick’s room brings drunken revelers to view Merrick for a fee, giving the villainous Bytes the opportunity to kidnap Merrick and spirit him off to Belgium and a desperate existence as an abused and degraded sideshow freak.

Eventually, the other members of the freak show free Merrick and send him back to London, where, in a dramatic chase scene, he is pursued by an angry mob until the police arrive. Treves is summoned and reinstalls Merrick in his rooms at the hospital. Merrick is then celebrated by society when he attends his first theater performance. That night, he arranges himself to be able to sleep lying down, like a “normal person,” a position he knows will lead to his asphyxiation due to the size of his head, and he dies.

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