Showing 21 - 30 of 429 annotations tagged with the keyword "Professionalism"
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.
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.
Summary:Beginning in 1992, Mark Duxbury and Dean McClellan are high-flying salesmen for Johnson and Johnson, Ortho branch – happily promoting the drug Procrit, (or Epogen -- erythropoietin), for anemia. The drug stimulates the bone marrow to produce more red blood cells. Developed by fledging company Amgen, it was licensed to Ortho for specific uses. Their careers take off, and they earn bonuses and stature, peaking in 1993. Soon, however, Duxbury realizes that he is being encouraged to promote the drug for off-label uses and in higher doses that will enhance sales and profits through kickbacks. He soon realizes that the drug is not safe when used in these situations. People are dying because their unnaturally thickened blood results in strokes and heart attacks.
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.
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.
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.
Summary:This fine collection of work by Audrey Shafer is subtitled "Poems by a Doctor/Mother." The book begins with a section containing poems of personal history and experience ("that I call home"), descends into the nether world of anesthesia ("not quite sleep"), and in the final section returns to the light with a new perspective on the texture and occurrences of ordinary life ("okay for re-entry").Among the more medically oriented poems, see especially "Spring," "Anesthesia," "Three Mothers," Monday Morning (see annotation in this database), "Gurney Tears," "Center Stage," and "Reading Leaves." "Don’t Start, Friend" takes up the topic of substance abuse among anesthesiologists (or physicians, in general).
Summary:The poet, an anesthesiologlist and mother, describes her early morning departure from home as she prepares to begin her professional day, leaving behind her little son and the physical and emotional warmth of their relationship. After arriving at work, she readies the operating suite for her first patient, taking pleasure in "the rote motions," noting that "all is bright pristine ordered."Having made the transition from home to work she tries to remember her son’s "just-awakened warmth." The poem ends with the arrival of her patient, who is naked and ready to be put to sleep (anesthetized), inverting the opening image of her sleepy, naked child and their leave-taking.
Summary:The author, an experienced surgeon, believes that we will be less frightened by the prospect of death if we understand it as a normal biologic process. He points out that 80 percent of deaths in this country now occur in hospitals and are therefore "sanitized," hidden from view, and from public comprehension. He describes the death process for six major killers: heart disease, stroke, AIDS, cancer, accidents/suicide, and Alzheimer's disease.But the power of the book is in its intensely personal depiction of these events and in the lessons which Nuland draws from his experiences. The message is twofold: very few will "die with dignity" so that (1) it behooves us to lead a productive LIFE of dignity, (2) physicians, patients, and families should behave appropriately to allow nature to take its course instead of treating death as the enemy to be staved off at any cost. Only then will it be possible for us to die in the "best" possible way--in relative comfort, in the company of those we love/who love us.
Summary:The author, Professor of Psychiatry at Johns Hopkins University School of Medicine, is an authority on manic depressive illness. With this powerful, well-written memoir she "came out of the closet," publicly declaring that she herself had suffered from manic depressive illness for years. Jamison describes the manifestations of her illness, her initial denial and resistance to treatment with medication, attempted suicide, and her struggle to maintain an active professional and satisfying personal life.The author was "intensely emotional as a child," (p.4) and in high school first experienced "a light lovely tincture of true mania" (p.37) during which she felt marvelous, but following which she was unable to concentrate or comprehend, felt exhausted, preoccupied with death, and frightened. (pp. 36-40) Interested in medicine as an adolescent, she pursued her goal in spite of mood swings and periods of mental paralysis. Jamison completed graduate work in clinical psychology; shortly after obtaining a faculty appointment "I was manic beyond recognition and just beginning a long, costly personal war against a medication that I would, in a few year’s time, be strongly encouraging others to take [lithium]." (p. 4)Jamison eventually, through strong support from friends and colleagues, excellent psychiatric care, and her own acceptance of illness, has been able to reach a state of relative equilibrium--tolerable levels of medication (fewer side effects) and dampened mood swings. But she makes clear that she must stay on lithium and remain vigilant.