Showing 21 - 30 of 38 annotations in the genre "Collection (Essays)"
Physician-scientist Lewis Thomas turns to pressing, threatening issues in this collection of 24 essays, many of which have been published in Discover magazine. The book opens and closes with meditations on nuclear warfare--the atom bombs of World War II and the escalation of worldwide tensions and technology that can combine to destroy the human race. In between, other essays, such as "On Medicine and the Bomb" and "Science and 'Science,'" also focus on these issues.
Less apocalyptic essays concern Thomas's experience with requiring a pacemaker, the state of psychiatry, lie detectors as evidence for essential human morality, and his abiding interest in language and scientific research.
This book contains 29 short essays by physician-scientist Lewis Thomas, originally published in the early 1970s in The New England Journal of Medicine. The essays center on science, and range in focus from the molecular (e.g., DNA) to the subcellular to the organism to social interactions and all the way up to the search for extra-terrestrial life. Some themes reappear in several essays: science as a grand, engaging enterprise worthy of the brightest minds; communication between organisms creating the intricate dance of the social organism; the relationship of man to both nature and the grand scheme of the universe.
Lewis is fascinated by communication not only at the cellular level, but also at the pheremonal and cerebral level: "Language, once it comes alive, behaves like an active, motile organism" (90). The ant and its colony, as an example of a simultaneous individual and integrated social organism, form a link for Thomas between the enclosed unit of a cell and the complex interactions of a society. Indeed, macro-micro comparisons continue throughout the essays, and even conclude the final essay, "The World's Biggest Membrane," which lauds the atmosphere as protector, filter, and provider: "Taken all in all, the sky is a miraculous achievement. It works, and for what it is designed to accomplish it is as infallible as anything in nature. . . it is far and away the grandest product of collaboration in all of nature" (48).
This masterful collection of essays was written by Gawande while he was a general surgery resident. The book consists of fourteen essays divided into three sections: Fallibility, Mystery, and Uncertainty. Although some of the essays fall clearly within the boundaries of the section title (such as "When Doctors Make Mistakes" and "When Good Doctors Go Bad" in the Fallibility section), others cross boundaries or don’t fall as squarely in these general themes ("Nine Thousand Surgeons," an anthropological essay on the cult and culture of a major surgical convention, is also located in the Fallibility section). Nevertheless, the many pleasures of the individual essays, the range of topics explored in depth, and the accuracy of the medicine portrayed are the true strengths of this work.
The book begins Dragnet-style with an Author’s Note: "The stories here are true." (p. 1) And it is this attention to fidelity that makes the essays so compelling. Because even when the truths are hard--the terrible acknowledgment by the medical neophyte about lack of skill and knowledge, the mistakes in judgment at all levels of doctoring, the nature of power relations and their effects on medical pedagogy and on the doctor-patient relationship, the gnawing uncertainties about so many medical decisions--the author confronts the issues head on with refreshing rigor, grace and honesty.
Many of the essays reference scientific and medical research (historical and current) as part of the exploration of the topic. This information is imbedded within the essay, hence avoiding a dry recitation of statistical evidence. Typically, the reader’s interest in an essay is immediately piqued by a story about a particular patient. For example, the story of an airway emergency in a trauma patient, her oxygen saturation decreasing by the second as Gawande and the emergency room attending struggle to secure an airway, surgical or otherwise, sets the scene for "When Doctors Make Mistakes."
This leads to a meditation on not only the culture of the Morbidity and Mortality Conference, with its strange mix of third-person case narrative and personal acceptance of responsibility by the attending physician (see Bosk, Charles, Forgive and Remember: Managing Medical Failure, U. Chicago Press, 1981 for an in depth analysis of this culture), but also a positive examination of the leadership role that anesthesiologists have played in improving patient safety via research, simulator training and systems improvement.
Gawande’s journalistic verve takes him beyond the confines of his own hospital and training to interview patients and physicians on topics as diverse as incapacitating blushing ("Crimson Tide"), chronic pain ("The Pain Perplex"), malpractice and incompetence ("When Good Doctors Go Bad") and herniorraphy ("The Computer and the Hernia Factory"). In addition, he visits his own post-operative patients at home ("The Man Who Couldn’t Stop Eating" and "The Case of the Red Leg") which gives a longer view of postoperative recovery and a broader exposure to patients’ perspectives.
Some of the most telling moments come with the introduction of his children’s medical problems into the text. These range from the relatively straightforward (a broken arm, but a chance to comment on detection of child abuse in the emergency room) to the downright parental nightmare scary (severe congenital cardiac defect in their oldest child and a life-threatening respiratory infection in their prematurely born youngest).
These last two experiences are introduced to provide an angle on issues of choice. Choice of a fully trained, attending physician rather than a fellow to provide follow-up cardiac care for their oldest, and the choice to opt out of the decision-making process for whether to intubate the trachea of the youngest and hence leave the medical decisions up to the care team.
Under the aegis of the Association of American Medical Colleges and its journal, Academic Medicine, the editor of the Medicine and the Arts column has collected 100 selections for publication in this volume. Each selection is made up of a piece of literature or art relevant to the medical humanities, followed by a commentary that elucidates or elaborates upon the contribution of the primary piece to the practice of medicine.
Given the wide-ranging nature of the art and literature in this collection, essentially every keyword listed in this database could come into play; those denoted above identify broad categories under which fall the works discussed. The artists represented vary from poets of the classical period, to ancient and modern painters, to writers who study the human condition in their fiction or essays. The scope is enormous; the adventure daunting.
Spencer Nadler, a surgical pathologist for over 25 years in southern California, offers 8 essays, as well as an introduction, epilogue and 9 full color histopathology plates in this collection. As he explains in the introduction, Nadler began his training in surgery, but, during a required year of surgical pathology, he finds his true vocation: "I realized a flair for surgical pathology that I had never demonstrated in surgery." (p. xix) However, over the years, he realizes he misses patient contact--these essays, written over 10 years, are forays into an unusual relationship: the pathologist-patient relationship.
Each essay is about a different patient (or other contact) and tissue. One of the most compelling is the first, "Working Through the Images," in which a woman (Hanna Baylan) with metastatic breast cancer seeks Nadler out so that she may view her cancer cells. She arrives in his office unannounced at 6 p.m. and he proceeds to not only show her the slides, but to listen to her. He becomes a witness to her pain, loneliness, sorrow and hope.
"For years I have processed thousands of such cases, determined the manifold forms of disease, but I've never been an intimate part of anyone's illness, never felt the connections of cells to a larger self." (p. 12) During later visits, Baylan cries in his arms and even brings her youngest son in to meet Nadler and view her cells. By this time, Nadler is completely connected to her: "This is heartrending to me, for I have come to love her . . . I can no longer think of Hanna in terms of the cells I see on her slides." (p. 21)
Other chapters highlight fat and bariatric surgery; neurologic disorders such as brain tumor, Parkinson's, Alzheimer's and paraplegia; heart disease; sickle cell disease; and palliative care. Each chapter conveys Nadler's visual sophistication and ability to graphically describe cells. For instance, within a fat cell "a large fat globule steamrolls other cell contents flat against the outer membrane until it bulges like a mozzarella." (p. 32) More importantly, Nadler ably extends his cellular acuity to the larger human dimension.
This book is composed of a series of essays written by Dr. Percy over a period of twenty years from 1954 to 1975. All have been published in journals except the last one, "A Theory of Language." The first one was written before his first novel, The Moviegoer, was published. These all reflect his recurring interest in the nature of human communication.
The first essay, "The Delta Factor," is perhaps the easiest to understand. It has a long subtitle: "How I Discovered the Delta Factor Sitting at my Desk One Summer Day in Louisiana in the 1950's Thinking About an Event in the Life of Helen Keller on Another Summer Day in Alabama in 1887." Percy asks why man feels so sad in the twentieth century; he goes on to state that this book is about two things: man's strange behavior, and man's strange gift of language and how understanding the latter might help understanding of the former.
Percy's view is that man's singular asset, which differentiates him from animals, is language. His interest in language and how children acquire language is almost certainly related to the fact that one of his daughters is deaf, hence also his interest in Helen Keller. Subsequent essays are further approaches to these questions, including the importance of symbolization as an essential act of the mind and a basic human need.
The essay, "The Message in the Bottle" is built around the supposition that a man who is a castaway on an island and has no memory of his past life finds on the shore a series of bottles which contain messages. The man, who has become a useful member of the island community, must decide which messages appear to state empirical facts and which seem to refer to the nature of reality. Dr. Percy sees that the messages can be in some ways like the news of the Christian faith. This fits with his own personal way of dealing with a feeling of alienation by turning to religion. He sees belief in one of the theistic historical religions as a way to redeem man from the catastrophe which has overtaken him. He describes not only himself but also man as a castaway who can recognize his need and have hope that some message might relieve his predicament.
Leap into the world imagined by Kurt Vonnegut, WNYC's reporter on the afterlife, and land with him at the Pearly Gates, or more precisely, "the hundred yards or so of vacant lot between the far end of the blue tunnel and the Pearly Gates" (8). There, Vonnegut, forever the humanist, has his interviewees talk about that which is of ultimate importance--how they lived (or should have lived) their lives.
Vonnegut begins his journeys from the state-of-the-art lethal injection facility in Huntsville, Texas, and reaches his destination though the able assistance of Jack Kevorkian. Who does he meet at the mid-point of his round trip journeys? Dead folks--many famous ones, some not so famous--21 in all (including his fictional creation, Kilgore Trout). Also on the list of interviewees are John Brown, Clarence Darrow, William Shakespeare, Mary Wallstonecraft Shelley, Karla Faye Tucker (actually put to death in the Huntsville facility), and Isaac Asimov.
This collection of 20 essays continues and expands upon the theme--how we living care for our dead and incorporate them into memory--that Thomas Lynch, a poet and undertaker, introduced in his first book, The Undertaking: Life Studies from the Dismal Trade (see this database).
In this new book, Lynch writes rambling pieces that begin with some observation about his funereal trade then blaze off into musings about religion ("The Dead Priest"), love and divorce ("The Blindness of Love," "Y2Cat"), poetry ("Reno," "Notes on 'A Note on the Rapture to His True Love'"), and the interplay of mortality and morality ("Wombs," "The Bang & Whimper and the Boom"). In his first book, Lynch wrote scathingly of abortion and mercy killing, and here he continues his thought provoking considerations of both.
In what might be the most interesting and radical essay in this collection, "Wombs," Lynch walks a precarious line between pro-life and pro-choice rhetoric; ultimately, he asserts a woman's right to abhor decisions about her body that "leave her out." At the same time, he asks if the reproductive choices available to women, "when considered for men," might not seem "irresponsible, overly indulgent, and selfish." What if, he writes, men could declare (without stating their reasons) their interest in their unborn children "null and void, ceased and aborted?" Lynch, who spends most of his time in the contemplation of the deceased, seems to find in death a spark of life; then he fans it into flame with language.
A 199-page collection of twelve essays by undertaker and poet Thomas Lynch, superficially about his mortuary trade, but actually about much more--life and death; the process of mourning; how we human beings pass though our common lives with grace or desperation; how the graveside ritual serves memory, family, and society. In the preface, Lynch says that early on he came to understand that the undertaking trade he would inherit from his father had little to do with what was done to the dead, but everything to do with how the living responded to the deaths of loved ones, neighbors, and friends.
Particularly outstanding essays include "The Undertaking," in which Lynch divulges the practical and emotional secrets of his trade as he buries Milo, a man who owned a Laundromat; "Crapper," a humorous, rollicking essay that demonstrates our modern society's inability to deal either with the thought of dying or the actual dead body; "The Gulfatorium," a flight of fancy about building a graveyard in a golf course, but really about the nature of suffering and the afterlife; "Mary & Wilbur," about neighbors, about our fear of death and our impulse to memorialize; "Uncle Eddie, Inc.," about an uncle's "clean-up service" that sanitized rooms after messy suicides and about the natural order of life and death and the moral implications of our manipulation of that order through assisted suicide, abortion, and genetic manipulation. My personal favorite is the final essay, "Tract," in which Lynch says how he wants his own death and burial to be managed, how he, a witness to our final rituals, wants to be witnessed.
This is a collection of autobiographical essays, most of them previously published in magazines or adapted from radio talks. "Return Ticket to Cardiff" describes Abse's pilgrimage in 1978 to visit the house in which he was born. "A Skull in the Wardrobe" and "Notes Mainly at the Clinic" draw upon the author's medical training and practice experience. Other pieces like "Pages from a Princeton Journal," "A Voice of My Own," and "Pegasus and the Rocking Horse" reveal Dannie Abse, the poet and writer.