Showing 21 - 30 of 471 annotations tagged with the keyword "Art of Medicine"

The Heart

de Kerangal, Maylis

Last Updated: Apr-25-2016

Primary Category: Literature / Fiction

Genre: Novel

Summary:

The story of The Heart is a simple, linear structure.  A car accident renders a young Frenchman, Simon, brain-dead. A medical team proposes harvesting organs, and his parents, after some turmoil, agree. That’s the first half of the book, the provenance of this specific heart. The second half describes its delivery for transplantation. Administrators find recipients, one of them a woman in Paris. Simon’s heart is transported there by plane and sewn into her chest. All this in 24 hours.  
            
The narration is complex, with flashbacks, overlapping times, and literary art that is compelling. There are 28 sections to the story but without numbers or chapter headings, and these are often broken up into half a dozen shorter sections. We have an impression of stroboscopic flashes on the action, with high intensity focus. These create a mosaic that we assemble into dramatic pictures. Even major characters arrive without names, and we soon figure them out.  
 

Simon.  He’s called the donor, although he had no choice in the matter. At 19 years of age he’s trying to find a path in life.  A Maori tattoo is a symbol for that search. He has a girlfriend, Juliette. He fades away as a character (except in others’ memories) and his heart takes center stage.  

Marianne and Sean, Simon’s parents.  Her emotions, as we would expect, range widely, especially during discussion of whether Simon’s organs can be transplanted. Father Sean has a Polynesian origin and cultural heritage.


Pierre Révol, Thomas Rémige, and Cordélia Owl are respectively the ICU physician, nurse, and the transplant coordinator. These are vividly drawn, with unusual qualities. Skilled professionals, they are the team the supplies the heart.  

Marthe Carrare, Claire Méjan, and Virgilio Breva are a national administrator, the recipient, and a surgeon. Described in memorable language, they are the receiving team.              

The characters’ names give hints of de Kerangal’s range. S
ince the 1789 Revolution Marianne has been a well-known French national symbol for common people and democracy, but Virgilio Breva is from Italy and Cordélia (recalling King Lear) Owl (as in wise?) has a grandmother from Bristol, England. We learn of personal habits regarding tobacco, peyote, sex, and singing. Medicine is part of a larger world of people of many sorts.              

Even minor characters, such as Simon’s girlfriend Juliette and other medical personnel are touching and memorable.
             

These characters animate the story with their passion, mystery, even heroism. While we don’t know the final outcome of the implanted heart, the text shows the professionalism of the medical team, the French national system that evidently works, sensitive care of patients and families, and in the last pages, rituals of affirmation for medical art and for patients.
             

There is richness in de Kerangal’s style. At times it is direct, reflecting the thoughts of characters. At times it is ornate, even baroque. She uses many images and metaphors, often with large, epic qualities. A very long sentence about the over-wrought parents describes them as “alone in the world, and exhaustion breaks over them like a tidal wave” (p. 141).  The style uses many similes, often with dramatic and unexpected comparisons. There are references to geology, astronomy, even American TV hospital drama. The style is at times lyric…we might say “operatic.”  One page about Cordélia is very, very funny.
        
  
In a different tone, the details of medicine, law, and ethics are carefully presented, and visual imagery puts us in the hospital rooms, the OR, and crowded streets around a soccer game. Throughout it appears that translator Sam Taylor has done an admirable job. 
             

The text invites us to consider large visions of wholeness. All the major characters seek some comprehensive unity to their lives, and they avoid orthodoxies such as religion, patriotism, and economic gain. Sean has his Polynesian heritage and boat-building passion, which he has shared with Simon. Cordélia, at 25, is an excellent nurse, wise beyond her years in some ways, but is as dazzled by a man as any teenaged girl. Nurse Rémige has his master’s in philosophy, loves the song of rare birds, and is, himself, a serious singer.  

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Attending Others

Volck, Brian

Last Updated: Apr-11-2016
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

This memoir of a life in medicine takes the writer from St. Louis to a Navajo reservation to Central America to the east coast and from urban hospitals to ill-equipped rural clinics. It offers a wide range of reflections on encounters with patients that widen and deepen his sense of calling and  understanding of what it means to do healing work.  He learns to listen to tribal elders, to what children communicate without words, to worried parents, and to his own intuition while calling on all the skills he acquired in a rigorous medical education.  Always drawn to writing, Volck takes his writing work (and play) as seriously as his medical practice, and muses on the role of writing in the medical life as he goes along.

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Annotated by:
Glass, Guy

Primary Category: Literature / Plays

Genre: Essay

Summary:

This is a collection of essays by (mostly British) artists, performers, and academics on the intersection between medicine and theater.  It appears in a series entitled “Performance and Science: Interdisciplinary Dialogues” put out by Bloomsbury Methuen Drama.  The introduction makes it clear there are many points of convergence beyond the scope of this volume, such as how medicine is depicted in plays and therapeutic uses of theater (e.g. drama therapy).  The focus here, then, is on “the ways in which the body is understood, displayed and represented in performance” (p. 11).  And the “medical body” of the title refers to one that is ’acted upon’ by illness or disability and/or by the diagnostic and therapeutic activities of the medical profession” (Ibid).  

The book is divided into three sections: “Performing the Medical,” “Performing Patients,” and “Performing Body Parts.”  The first section includes an essay by Roger Kneebone, a surgeon, who explores the parallels between his field and theatrical performance.  Kneebone has devised simulations that enable laypersons to get a sense of what it is like to participate in surgery.  In his view, this encourages cross-fertilization of ideas.  For example, his collaboration with a jazz pianist has demonstrated to him that musical improvisation, in its spontaneity, is somewhat like emergency surgery.  And his work with a choreographer led to the development of a dance piece depicting the movements of a surgical team during a procedure.   
 

In the second section we read about Brian Lobel, a theater artist who has used his experience with testicular cancer to create a solo performance piece entitled “BALL.”  This not only allowed Lobel to “regain a sense of mastery over the illness experience” (p. 88), but has also earned him a niche within the theater community.  Lobel now works with other cancer sufferers helping them develop their own narratives in a project called “Fun with Cancer Patients.”  

The final section of the book includes a description of “Under Glass,” a forty-minute performance piece consisting of eight specimen jars each containing a solo performer, said to be “at once museum exhibit, gallery and medical laboratory” (p. 141), which also provides the book's front cover image. "Under Glass" was devised by Clod Ensemble, whose Performing Medicine project is known for its teaching programs in numerous London medical schools.  Meant to provoke discourse about the public display of specimens, it brings to mind the Victorian “freak show” as well as the more recent controversial touring Body Worlds exhibition of plastinated cadavers and body parts.

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The Death of Cancer

DeVita, Vincent

Last Updated: Feb-04-2016
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

The book offers a detailed account by one of the nation’s leading cancer researchers of developments in chemotherapy over the past several decades, as well as the recent history of surgical and radiation treatments in the “war on cancer”—a term he resisted at first but finally embraced with full understanding of its implications.  The narrative touches on many of the writer’s own struggles over economic, political, and moral implications of what a NYT reviewer described as a “take-no-prisoners” approach to cure.  He also includes stories about disagreements with other researchers that give some insight into the acrimony that is part of high-stakes science.  At the NIH and later as head of the National Cancer Institute, DeVita faced many decisions about distribution of resources, how much to put patients at risk, and whom to include in clinical trials.  He provides his own point of view on those controversies frankly.  Not much mention is made of the causes of cancer, of nutritional or other complementary approaches, or the environmental factors in the spread of cancer. The strong focus on the book is on the development of chemotherapeutic treatments that have succeeded in raising survival rates, though few current statistics are cited.

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Annotated by:
Kohn, Martin

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

Brian Dolan has done a great service for the field of medical humanities through his efforts in putting together this volume. Its 19 reprinted articles cover the spectrum of disciplines/fields/methodologies that anchor our work:  history, literature, film, theater, arts, narrative, storytelling, critical (disability) studies, human values, and professionalism. His opening essay, “One Hundred Years of Medical Humanities: A Thematic Overview” very pertinently and extremely ably sets the stage for the remainder of the book. Quite helpfully, authors of “recently published articles,” in this instance from 1987 on, were asked “to reflect on their piece and add introductory comments that would help frame it, or enable them to address issues raised since its original publication” (p.167).  To the reader’s benefit, almost all of those contemporary authors did so.  As cited on the book’s  back cover, the work of some of our field’s most important educators are in this volume, including contributions from Erwin Ackernecht, Gretchen Case, Rita Charon, Jack Coulehan, Thomas Couser, Lester Friedman, Kathryn Montgomery Hunter, Paul Ulhaus Macneill, Guy Micco, Martha Montello, Edmund Pellegrino, Suzanne Poirier, Johanna Shapiro, Abraham Verghese, and Delese Wear. 

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Call the Midwife

Worth, Jennifer

Last Updated: Dec-15-2015
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Many are familiar with these stories from the author's practice as a midwife among the urban poor in London's East End in the 1950s.  Each piece stands alone as a story about a particular case. Many of them are rich with the drama of emergency interventions, birth in complicated families (most of them poor), home births in squalid conditions, and the efforts of midwives to improve public health services, sanitation, and pre- and post-natal care with limited resources in a city decimated by wartime bombings.  As a gallery of the different types of women in the Anglican religious order that housed the midwives and administered their services, and the different types of women who lived, survived, and even thrived in the most depressing part of London, the book provides a fascinating angle on social and medical history and women's studies.

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Skin for Ricky

Schiedermayer, David

Last Updated: Dec-10-2015
Annotated by:
Nixon, Lois LaCivita

Primary Category: Literature / Poetry

Genre: Poetry

Summary:

The physician-narrator is looking in on a 30 year old patient named Ricky. Readers immediately learn that the patient has cerebral palsy: his ear mashed flat, his neck contorted into a tight C, almost quadriplegic. These first stanza clinical observations are indisputable. The narrator then shifts from the medical facts to more subjective thoughts ranging from Ricky’s previous treatment responses and medications to Ricky’s adult heterosexual response to the proximity of a female, and finally to the narrator’s own wishes for this patient. Ricky’s parents, the narrator notes, have similarly but uncomfortably witnessed their son’s ogling response to a pretty nurse or doctor or a provocative adult television image. The parents’ response, he notes, to these observations has been to redirect Ricky’s focus by switching the channel to Nickelodeon, a program geared towards children.  Not unlike situations in several writings by William Carlos Williams, this physician has moved from objective medical information to his own interior thoughts about Ricky’s circumstances and confinement.  Rather than sticking with the facts associated with the patient’s medical condition, he wonders, imagines, and expresses in this poem seemingly un-doctorly thoughts. 

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The Physician

Gordon, Noah

Last Updated: Nov-17-2015
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

When nine-year-old Rob Cole, child of poor 11th-century English farmers, loses his mother, he is consigned to the care of a barber-surgeon who takes him around the countryside, teaching him to juggle, sell potions of questionable value, and assist him in basic medical care that ranges from good practical first-aid to useless ritual.  When, eight years later, his mentor dies, Rob takes the wagon, horse, and trappings and embarks on a life-changing journey across Europe to learn real medicine from Avicenna in Persia.  Through a Jewish physician practicing in England, he has learned that Avicenna’s school is the only place to learn real medicine and develop the gift he has come to recognize in himself.  In addition to skill, he discovers in encounters with patients that he has sharp and accurate intuitions about their conditions, but little learning to enable him to heal them.  The journey with a caravan of Jewish merchants involves many trials, including arduous efforts to learn Persian and pass himself off as a Jew, since Christians are treated with hostility in the Muslim lands he is about to enter.  Refused at first at Avicenna’s school, he finally receives help from the Shah and becomes a star student.  His medical education culminates in travel as far as India, and illegal ventures into the body as he dissects the dead under cover of darkness.  Ultimately he marries the daughter of a Scottish merchant he had met but parted with in his outgoing journey, and, fleeing the dangers of war, returns with her and their two sons to the British Isles, where he sets up practice in Scotland.

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A Lucky Life

Goldbloom, Richard

Last Updated: Nov-11-2015
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Nonfiction

Genre: Autobiography

Summary:

Born into a Montreal Jewish family in 1924, Richard Goldbloom was always sensitive to minorities and at ease with difference. Jewish and Christian, French and English, music, theatre, and the arts in all forms were prevalent and valued in the family home. He became a skilled pianist and a gifted storyteller. Richard trained in medicine with his father and at McGill University then specialized in pediatrics at Harvard with the famous Charles A. Janeway at Boston Children’s Hospital.

He met the vivacious, intrepid Ruth Schwartz at McGill when they both auditioned for a play. Also Jewish, she hailed from Cape Breton Island, Nova Scotia. They married in 1945 before his studies were complete and had three children. Unlike many male physicians of his era, Richard was in awe of this tiny dynamo and attributes his happiness and success to her.

In 1967, the family moved to Halifax, Nova Scotia, where Richard became Professor of Pediatrics, Physician in Chief and director of research at the new children’s hospital. Ruth was instrumental in a wide array of philanthropic endeavors that inevitably involved her husband. She developed a remarkable museum at Pier 21, the point of arrival for generations of immigrants to Canada—a place to gather their stories and their achievements.

Many anecdotes about clinical practice and scientific innovations are told with accessible enthusiasm and gentle humor. He dispels myths, exposes hidden agendas and explains with clear examples the importance of listening to children and their parents. Underlying the entire narrative is a refreshing humility and gratitude for his “lucky life.” 

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Black Man in a White Coat

Tweedy, Damon

Last Updated: Nov-09-2015
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

This memoir focuses on the various ways in which his being an African American affected Tweedy’s medical education and early practice as a medical resident and later in psychiatry. Raised in the relative safety and privilege of an intact family, he found himself underprepared for some of the blatant forms of personal prejudice and institutional racism he encountered in his first years of medical education at Duke Medical School.  One shocking moment he recounts in some detail occurred when a professor, seeing him seated in the lecture hall, assumed he’d come to fix the lights.  Other distressing learning moments occur in his work at a clinic serving the rural poor, mostly black patients, where he comes to a new, heightened awareness of the socioeconomic forces that entrap them and how their lives and health are circumscribed and often shortened by those forces.  Well into his early years of practice he notices, with more and more awareness of social contexts and political forces, how the color line continues to make a difference in professional life, though in subtler ways.  The narrative recounts clearly and judiciously the moments of recognition and decision that have shaped his subsequent medical career.    

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