Showing 201 - 210 of 808 annotations tagged with the keyword "Communication"

Summary:

This DVD, a documentary of a medical student retreat to a museum, illustrates an approach to cultivating empathic understanding in medical students and residents by using the visual arts.  Florence Gelo, D.Min, created the arts program and the video. She is Behavioral Science Coordinator, Family Medicine Residency, Drexyl University College of Medicine. Students observe closely four paintings and are encouraged to experience their feelings about what they are seeing, and to express those feelings. The paintings are Prometheus Bound (Peter Paul Rubens 1618), Massacre of the Innocents (Pacecco de Rosa 1640), Rachel Weeping (Charles Wilson Peale 1618), and The Agnew Clinic (Thomas Eakins 1889; see annotation in this database).

Prometheus Bound is a disturbing scene of an eagle ripping the liver out of Prometheus. Students comment on the nakedness. the vulnerable position and the helpless expression on the face of this strong man, and on the eye contact between the eagle and Prometheus. In Massacre of the Innocents Dr. Gelo calls our attention to the faces of the mothers, helpless to save their children from the swords. In Rachel Weeping Gelo asks the students if they noticed the vials of medicine before the days of allopathic medicine.  Did they notice the one tear dropping from Rachel's face? (Peale added the medicine vials and his wife weeping to the original portrait of his infant daughter Margaret who died of smallpox.)

Two physician speakers, Horace DeLisser, and Rhonda Soricelli provide additional commentary about how engagement with a painting is similar to engaging with a patient, and how learning technology-focusing on the scientific and the medical- detracts students from learning to look at the big picture and the humanistic side of medicine.  Traditional medical education does not teach doctors to be present to patients, to sit by their sides, to listen and invite dialogue of suffering and to not deny those aspects of what it means to be ill.  Dr. DeLisser further acknowledged his personal struggles with feelings of frustration, anger and grief when patients died in the ICU.  The importance of talking about the vulnerability of physicians, the concerns about what else they might have done, propelled him to develop Grieving Rounds.

A cancer survivor contrasts a "callous" physician's response to her care with  another physician who exemplified someone who has the expertise not only around the disease, but  has the ability to acknowledge the whole person and offer his companionship to be there to the very end: "...what we're going to do is....We'll take this step by step."


 

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The Diagnosis

Lightman, Alan

Last Updated: Jan-21-2010
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Novel

Summary:

While riding on a commuter train, Bill Chalmers suddenly forgets who he is and where he is headed. His amnesia is accompanied first by a numbness of his hands and then later his legs. Eventually he is confined to a wheelchair and dependent on his family and a home nurse to care for him. Despite extensive testing and consultations with a variety of doctors, no one can make a definitive diagnosis of his illness.

Chalmers is subjected to many empirical treatments including antidepressants, steroids, plasmaphoresis, and psychotherapy, but his health continues to deteriorate and he loses his job. His wife and son become victims of his predicament. By the end of the story, Chalmers gains insight into his life and discovers that only his dignity still remains in his control.

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The Pearl Diver

Talarigo, Jeff

Last Updated: Jan-21-2010
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Leprosy looms large in this story about transformation and loss set in post World War II Japan. A nineteen-year-old pearl diver notices a numb red spot on her forearm. Later on, another blemish appears on her lower back. These two lesions are manifestations of a mild case of leprosy. Her infection will be arrested by medication and never get any worse. The girl is forcibly transported to the Nagashima Leprosarium, an island where she will spend the rest of her life except for a few brief excursions and one extended "escape" at the age of sixty-four.

Despite the introduction of new and effective drugs--Promin (sulphone) and dapsone--authorities still fear allowing the leprous patients to return to society. Inhabitants of the sanatorium are admonished on arrival that their past is erased. Each individual must begin a new life and select a new name. The protagonist chooses the moniker Miss Fuji. She is a kind and sensitive young woman who eventually functions as a nurse and caregiver for the other patients incarcerated in the sanatorium. As a punishment, Miss Fuji is required to attend abortions and dispose of the dead fetuses.

As the decades pass, conditions on the island improve. The number of residents with leprosy still living there dwindles from about two thousand people to six hundred. Even a bridge connecting Nagashima to the mainland is constructed. It no longer matters. Emotional and psychological barriers remain. When Miss Fuji has an opportunity to create a new life for herself away from the sanatorium, she still returns to the place and the people that have been her home and family for so many years.

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Gilead

Robinson, Marilynne

Last Updated: Jan-21-2010
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Novel

Summary:

John Ames narrates this story in the form of a lengthy letter to his young son. Ames is a 76-year-old minister suffering from angina pectoris and heart failure. He has spent almost all of his life in Gilead, a small town in Iowa. His first wife died during childbirth along with a baby girl. Ames remarried a younger woman who is now 41. They have a son almost 7 years old.

Because Ames believes his death is close at hand, he pens a missive to the boy. Its purpose is to teach his son about all the important things in life Ames may not be around to share with him. During the course of composing the letter, Ames reflects upon his own existence. He recalls the experiences of his father and grandfather who were also ministers.

Reverend Ames likes to think, read, and pray. Born in 1880, he has lived through three wars, the Great Depression, a pandemic of influenza, and droughts. His hope is that his young son will grow into a brave and useful man.

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Saint Ursula and Her Maidens

O'Connell, Mary

Last Updated: Jan-21-2010
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Five women find fellowship and comfort in the swimming pool at a community center managed by Ursuline nuns. Each woman suffers from a chronic disease--lupus, multiple sclerosis, Crohn's disease, and rheumatoid arthritis. One is also being treated for ovarian cancer. The diverse group includes a pregnant woman, an elderly nun, and a retired nurse who currently peddles Avon products. On Tuesdays and Thursdays, they participate in aquatic therapy. The one-hour sessions temporarily soothe the body and boost morale. It is a welcome reprieve from the burden of disease and the complications of life.

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The Treatment

Robinson, Roxana

Last Updated: Jan-21-2010
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

When oral antibiotics are no longer effective, the narrator grudgingly consents to begin a six-week course of intravenous antibiotic therapy with Rocephin (a powerful, broad-spectrum antibiotic). She has an infection caused by spirochetes. The illness has been festering for as long as ten years but has only recently been diagnosed. It causes joint pain and stiffness. Her daughter has already been successfully treated for the same infection.

Every morning in her kitchen, the narrator performs the same ritual. She cautiously infuses the antibiotic and imagines that the golden fluid is extinguishing the corkscrew-shaped microbes. At first she experiences a drug reaction, but the event only convinces her that the treatment is actually working.

She senses that her husband and her friend are repulsed by the treatment (especially the syringes and IV apparatus). A visiting nurse, Ginger, comes to the house to perform minor maintenance on the intravenous line. She upsets the narrator with grim information about the infection and an account of a patient suffering from the same disease who is currently in awful condition. Dr. Kennicott, the narrator's physician, has not been so forthcoming about the course of the illness or pessimistic about the prognosis. The narrator chastises Ginger. Both women are now distressed. The narrator's immediate goal is to control her emotions and avoid crying.

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Thoreau's Laundry

Harleman, Ann

Last Updated: Jan-21-2010
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Celia has her hands full. The maxillofacial prosthetist is overwhelmed by the demands of caring for her ill husband at home. Her job - crafting replacement parts for people whose faces are damaged - is truly art but involves interacting with distraught patients and angry families. Her mother constantly telephones to offer unsolicited advice. Celia's husband, Simon, has multiple sclerosis. He has been treated in the emergency department many times and recently has been on a ventilator. Celia realizes that she unintentionally hurts Simon just by caring for him. She has never developed the knack of painlessly administering his injections. When she attaches the feeding pump to his G-tube (a feeding tube permanently set in the stomach), she induces pain by yanking too hard. Her mother, Bess, and best friend, Leslie, try to convince Celia that Simon would be better off in a nursing home, and her life would be less stressful. Although she has a lover, Celia cannot face losing her husband.

One of Celia's clients is an 8-year-old boy, Junius Jones. Most of his left ear was torn off after he was struck by a van. Celia constructs a silicone ear for the boy. She is deeply troubled when the boy's mother cancels his prosthetic fitting twice. Celia's mother is reading a biography of Henry David Thoreau and shares an inspiring quote by Thoreau with her daughter: "Live the life you've imagined" [p 120]. Perhaps Celia is incapable of imagining a hopeful future. Maybe Junius Jones and his mother are unable too.

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The Tennis Partner

Verghese, Abraham

Last Updated: Jan-20-2010
Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

A Doctor's Story of Friendship and Loss, this book is, in a sense, a sequel to Verghese's earlier memoir, My Own Country: A Doctor's Story of a Town and Its People in the Age of AIDS (see this database). The Tennis Partner tells the parallel stories of Verghese's disintegrating marriage as he establishes new roots in El Paso, Texas and of his new deep friendship with a (male) medical student who shares his passion for tennis. Both men are struggling to re-establish order in their personal lives: Verghese, in easing himself out of a dying marriage while trying to maintain a close relationship with his two sons; David (the tennis partner), in remaining drug-free and successfully completing medical training, which had been interrupted by his addiction.

Verghese, an experienced physician trained in infectious disease and an expert on AIDS treatment, relishes his role as David's mentor; David, a former tennis "pro," enjoys teaching Verghese how to play better. Playing tennis together for the sheer joy of it, each finds release. Tennis becomes the route through which each can unburden himself to the other, seeking solace in a difficult time. Through it "we found a third arena outside of the defined boundaries of hospital and tennis court . . . at a time in both our lives when friendship was an important way to reclaim that which had been lost." (339)

While the reader suspects that David must have a drug problem because the Prologue to the book, narrated in the third person, describes a "young doctor from El Paso" in drug treatment, Verghese the biographer has no inkling of the problem until one-third into his first person narrative. He is shocked, but in some ways the bonds of their friendship are strengthened. Each has only the other as a confidant.

David, however, has another addiction: women. The friendship becomes increasingly complicated as Verghese tries to remain both supportive and objective. Eventually David resumes "using" and Verghese must decide how to respond, both professionally and on a personal level. The turmoil in both lives ends tragically for David and causes profound grief in Verghese.

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Charming Billy

McDermott, Alice

Last Updated: Jan-20-2010
Annotated by:
Aull, Felice

Primary Category: Literature / Fiction

Genre: Novel

Summary:

The charming alcoholic, Billy, has been found unconscious, on a street in his home neighborhood of Queens, New York City. His cousin and lifelong friend, Dennis, must identify his body after he dies, and help his widow Maeve through the funeral and its aftermath--just as he has often helped Maeve to carry the stuporous Billy to bed. Billy's funeral is the occasion for the reminiscences about him by his friends and family that forms this novel's story. These reminiscences reveal the web of community and generational continuity that is at the narrative's core.

A central tragedy in Billy's life has often been invoked by his friends to account for his alcoholism. Recently back from the second World War, Billy had met the Irish girl, Eva, and fallen in love with her. When she returned to Ireland he was determined to bring her back, along with her family, so that they could be married. But, as the story goes, Eva died and Billy, heartbroken, never really recovered. We learn early on, however, that Eva's death was fabricated by Dennis, who could not bear to reveal to Billy and to the rest of the family that Eva had married an Irish beau and used the money that Billy had been sending her to set her new husband up in business.

Even though Billy eventually learns that Dennis has lied to him, their friendship is undiminished. Neither Billy nor Dennis enlighten anyone else with the truth, until Dennis tells his daughter, following Billy's funeral. It is as if the truth would force Dennis to confront the inexplicable--that a man so loved by all destroyed himself for no apparent reason, was unable to accept all efforts to help him, unable to help himself, and, in effect, abandoned and rejected those who cared for him. But the novel concludes with an affirmation of trust, faith (religious and secular), friendship, and family ties and with an acknowledgment that the stories we tell and believe may be more important than what actually happens to us.

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The Body Silent

Murphy, Robert

Last Updated: Jan-20-2010
Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Autobiography

Summary:

Robert Murphy was a professor of anthropology at Columbia University when he became progressively paralyzed by an inoperable spinal cord tumor. His book is a personal journey through profound physical disability, an exploration of the self, and a study of the social construction of disability ["Disability is defined by society and given meaning by culture; it is a social malady" (4)]. As he writes The Body Silent he is virtually quadriplegic, hitting the keys of his computer with the eraser end of a pencil held in place by a 'universal cuff' wrapped around his palm. He is still traveling to Columbia to teach his classes.

Murphy applies the metaphor of an anthropological field trip to his experience: "This book was conceived in the realization that my long illness with a disease of the spinal cord has been a kind of extended anthropological field trip, for through it I have sojourned in a social world no less strange to me at first than those of the Amazon forests. And since it is the duty of all anthropologists to report on their travels . . . this is my accounting" (ix). Drawing not only on his own experience but also on research for which he received funding, Murphy instructs his audience in the metaphysics of his situation, and in the social as well as physical challenges of disability.

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