Showing 201 - 210 of 558 annotations tagged with the keyword "Physician Experience"

The Shrine at Altimara

L'Heureux, John

Last Updated: Dec-05-2006
Annotated by:
Aull, Felice

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Written in a style resembling religious litany, this is the tale of a disastrous teen-age marriage and its criminal consequences. The setting is California. Maria is a poor Mexican-American who meets and attracts Russell, a working class Anglo. Although ambivalent, Maria sees marriage to Russell as the path to American, white respectability. Her earlier hopes of achieving this status through her own efforts have been frustrated by the reality of poor academic performance. She is eager to get away from the household of her deeply religious mother. Russell is brooding, taciturn, and carries the physical and psychic wounds of an abused childhood--his father is a partially reformed alcoholic who deliberately burned Russell's hand.

The pair are ill-equipped for marriage or parenthood and Maria soon feels trapped. Their son, John, avoids provoking them by being a "good boy," hoping to prevent their frequent arguments. Russell's deprived childhood accounts, perhaps, for his obsessively jealous fixation on Maria. He is jealous even of the attention she gives their son.

The catastrophe that seems always close at hand finally occurs: Russell sets fire to his own child. The second part of the novel is told primarily from John's perspective as he undergoes a prolonged, painful rehabilitation and tries to find meaning in these events. It is also the story of the plastic surgeon who attempts to restore John's horribly scarred body and who has come to doubt the purpose of his profession (there is nothing he can do about destructive family relationships and psychic scars). Russell, who has been brutalized in jail, is released, seeking redemption. Fire, significant throughout the story, plays a final shocking (redemptive?) role.

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Annotated by:
Holmes, Martha Stoddard

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Peter Selwyn spent the first ten years out of medical school at Montefiore Medical Center in the Bronx, caring for HIV-positive patients--mostly intravenous drug users and their families--in the early years of the AIDS crisis. As he worked with dying young men and women and their families, Selwyn returned to his own unexplored pain surrounding the loss of his father, who fell or (more likely) jumped from a 23-story building when Selwyn was a toddler. Mirroring their function in Selwyn’s life, the stories of the five patients who most affected him serve in this book as the threshold to the narrative of how Selwyn investigated, mourned, and commemorated his father’s death, finally revaluing it as central to the person and doctor he became.

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Animal Dreams

Kingsolver, Barbara

Last Updated: Dec-04-2006
Annotated by:
Belling, Catherine

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Cosima Nolinas (Codi) trained as a physician, but decided during her residency to give up medicine. As the novel opens, she is returning to her hometown, Grace, Arizona, to teach high school biology and care for her physician father, Doc Homero, who is suffering from Alzheimer's disease. Her younger sister, Hallie, has just left for Nicaragua to help with agricultural development. Codi's journey back to where she grew up reinforces a sense of aimlessness which she attributes to the death of her mother when she was three years old, to the miscarriage of an unwanted pregnancy when she was fifteen, and to her father's remoteness. She intends her stay to be temporary.

But gradually she is drawn into the community. She restarts a relationship with Loyd [sic] Peregrina, the Native-American father--though she never told him--of the child she lost in high school. She joins the town's struggle against a mining company that has polluted the town's water supply and now plans to dam the river. As her father's condition deteriorates, she learns more about the history of his connection with the town and, by examining the results of a life-long study he has done on a genetic anomaly affecting children born to second-generation inhabitants of Grace, she learns that her own hereditary background is far more deeply rooted in the town than she had known.

Codi's narrative is interspersed with her father's confused but illuminating memories of her childhood, and with the letters she receives from Hallie, who has always been the motivated and determined sister. When Hallie is kidnapped and then murdered by the contras, Codi's first response is to run away once more, but in laying her sister to rest and telling Loyd about their lost child, she realizes that she has found her home and--in her fierce and practical education of the new generation of Grace adolescents--her purpose.

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Bad Medicine

Querry, Ron

Last Updated: Dec-04-2006
Annotated by:
Belling, Catherine

Primary Category: Literature / Fiction

Genre: Novel

Summary:

This novel is based on the facts of an actual hantavirus outbreak that took place in the southwestern US in 1993, retelling the events as medical mystery, as ghost story, and as meditation on the relationship between rationalist western medicine and the beliefs of local indigenous cultures.

Dr. Push Foster is part Choctaw and part white, raised in Oklahoma. He returns to Arizona as an Indian Health Services physician at the time an outbreak begins of what is later identified as Hantavirus Pulmonary Syndrome. Western medicine and traditional health beliefs and practices overlap in the investigation and response to the illness as it infects and kills Navajo people.

Querry presents us with a convincing epidemiological investigation into the virus, but also suggests an alternative, or complementary, etiology for the outbreak: an archaeologist has stolen a sacred stone from the Hopi people with the help of a Navajo witch, or shape-shifter, the title's "bad medicine" practitioner. This theft, the novel suggests, is the reason that only Navajo, and one white person (the archaeologist's partner) become ill.

The climax of the story is a showdown between the shape-shifter, a Hopi village headman, and the ghost of a woman killed trying to save her people from the 1805 massacre of Navajo by Spanish troops at Muerto Canyon. (The virus, when first identified, was named Muerto Canyon Virus.) This woman becomes a figure of both vengeance and reconciliation, an uneasy meeting of cultures that echoes and informs the work of Push Foster and his colleague, Sonny Brokeshoulder: both are men of Indian blood with a "white" upbringing and who return to their culture bearing Western medical training, but do not deny the traditional knowledge either.

Unlike most medical thrillers, this book does not offer reductive explanations and answers; instead, we are left with the certainty that traditional and western thinkers must collaborate, not only to care for patients, but to take care of the natural environment on which all our health depends.

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The Good Doctor

Galgut, Damon

Last Updated: Dec-04-2006
Annotated by:
Belling, Catherine

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Frank Eloff, the novel’s narrator, is a white doctor working at a hospital in the former capital of one of South Africa’s now-defunct independent homelands (rural areas set aside by the apartheid government for black "separate development"). The hospital, in its deserted and decaying city, is understaffed and understocked, and there are hardly any patients. Those who do arrive usually need to be taken elsewhere if they need any significant treatment. The homeland’s former leader, the Brigadier, has returned as a criminal gang leader to loot the place, and a white former army commander, now in the employ of the present government, is trying to capture him.

Frank moved to this place when promised directorship of the hospital (and in flight after his wife left him for his best friend), but the previous director has not left yet, and Frank is in a kind of personal and professional bureaucratic limbo. He has a sexual relationship with a black woman who runs a roadside souvenir stall. It is not quite prostitution, not quite a love affair: she is married, speaks little English, and Frank regularly gives her money.

A new doctor, Laurence Waters, arrives. He is fresh from medical school, sent to the hospital in order to complete the rural community service year required by the government of all new physicians. He and Frank become roommates and begin an uneasy friendship. Laurence is an idealist, planning to make heroic changes, but he misunderstands the complex balance of tolerance, cynicism and patience that characterize survival at the hospital, and his well-intentioned efforts, such as trying to end theft from the hospital and to establish a clinic in a local tribal village, lead to disaster. The novel ends with Frank appointed hospital director at last, and things returning to their depressingly ineffective "normality."

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Her Final Show

Campo, Rafael

Last Updated: Dec-01-2006
Annotated by:
Aull, Felice

Primary Category: Literature / Poetry

Genre: Poem

Summary:

This poem by physician, Rafael Campo, is No. 5 in the sequence, "CanciĆ³n de las Mujeres" ("Song of the Women"). A drag queen is dying of AIDS, as she and the physician try to maintain her dignity and her identity. "Her shade of eye shadow was emerald green; / She clutched her favorite stones."

The patient is resigned, "almost at peace" while she remembers the strength that she drew from the community of drag queens who were her friends, now dead. The physician turns up the morphine drip, and straightens her wig, "[b]efore pronouncing her to no applause."

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Albert Schweitzer. The Enigma

Bentley, James

Last Updated: Nov-30-2006
Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Biography

Summary:

This book sketches the development of Schweitzer's ideas and accomplishments in theology, philosophy, musicology, and medicine. The author tends to pick up a theme at one time and then follow further developments on that theme at later points in Schweitzer's life. Thus, the book is not a comprehensive biography and it often departs from a strict chronological approach.

While there is some discussion of Schweitzer's "tortured" childhood and his later world-renown as the "jungle doctor," of Gabon, Bentley focuses on four intellectual and spiritual developments in Schweitzer's life. The first is his theological career, which led to the groundbreaking Quest for the Historical Jesus (1906) and subsequent theological books such as The Mysticism of Paul the Apostle (1930).

The second is his philosophy of "reverence for life, "which was first fully articulated in Civilization and Ethics (1923). The third is Schweitzer's career as a musician, musicologist, and organ designer. Finally, Bentley traces the development of Schweitzer's ministry as a medical missionary in Central Africa.

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Mr. Darwin's Shooter

MacDonald, Roger

Last Updated: Nov-30-2006
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Novel

Summary:

This novel recounts the fictional life of Syms Covington, an historical character who was Charles Darwin's servant during the voyage of the Beagle (1831-1836) and for two years thereafter in England. Covington then moved to New South Wales, but remained in correspondence with Darwin for the rest of his life. (He died in February 1861.)

MacDonald expands on these facts to create the engrossing story of an "elderly" Covington--he would have been in his mid-40's at the time--who befriends a young American physician in New South Wales. Covington develops appendicitis and MacCracken, the young doctor, saves his life. They become friends and during the next two years Covington gradually reveals his story.

The book flashes back to the voyage of the Beagle and reveals the development of Covington's prickly but worshipful relationship with Darwin. In 1860 Covington, who has become a wealthy landowner in New South Wales, anxiously awaits his copy of The Origin of Species. After enduring the agony and adventure, after studying thousands and thousands of specimens, how will Darwin bring it all together? The theory of evolution rocks Covington to the core. Has his work played a part in helping Darwin to develop this godless theory?

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The Patient Presents

White, Kelley Jean

Last Updated: Nov-30-2006
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

The title of this collection of poems recalls the formulaic statement by which a physician introduces a patient's medical problem or chief complaint. For example, "The patient presents with a history of fever, abdominal cramps and diarrhea for the last 24 hours." Or, "The patient presents with a long history of hypertension and diabetes." In this case, though, Dr. White's patients' presentations are poems, rather than chunks of sanitized medical jargon; and, while the patient remains a key character in most of these works, they also present the doctor's story.

Domestic violence, child abuse, and sexual abuse figure prominently in these poems. In "365" (p. 1) a five year old girl presents with "a foul smelling vaginal discharge"; she was a victim of rape. Baby "John Brown" (p. 9) has 47 fractured bones and was "dipped in boiling water" for soiling himself. In "Ironing" (p. 18) a first grade girl has the impression of an iron burned into her thigh. And the two-year-old girl in "Peek" (p. 49) is admitted to the Intensive Care Unit (ICU) with cigarette burns and a liver fracture.

Dr. White also writes of babies left behind by their mothers ("Autumn Angels," p. 3), homeless mothers and children ("Numbers," p. 42), and complex multigenerational family pathology ("Riddle," p. 50). All in all, these stories carry the reader very close to "Looking at the Gates of Hell" (p. 32).

Yet, a still, small voice of calm, maybe even of salvation, can appear in the most unlikely places. In "Belly" (p. 4) the physician lays her face against a baby's belly and "the warm brown skin calms my forehead. / All stiffness melts." In "Maplewood & Greene" (p. 36) she revels in seeing "three little girls on roller skates." And in the Whitmanesque poem called "Oh" (p. 45), she gloriously affirms, "Oh to laughter, oh to sorrow / Oh to a better day, oh tomorrow."

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The Private Life of Islam

Young, Ian

Last Updated: Nov-30-2006
Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Ian Young spent the summer of 1970 as a medical student working at a hospital in the province of Kabylia in Algeria. He was assigned to the Maternity department, where he worked primarily with two Bulgarian doctors. Most foreign medical personnel in Algeria at the time came from Eastern bloc countries, as "Islamic Socialism" was the official political system in the newly independent (1962) North African country. According to Young, obstetrical care for the mostly Berber women of the area was brutal, disorganized, antiquated, and dangerous.

Dr. Vasilev, the head of the department, is a passive and indecisive man, who spends most of his day reading the newspaper. Once roused from his lethargy, which doesn't happen very often, he demonstrates competence and concern for his patients. His colleague, Dr. Kostov, is an aggressively brutal man who introduces himself to pregnant patients by shoving his fist into their vaginas.

Both doctors excuse their behavior by saying, "We just can't do it here they way we do it in Bulgaria." For the most part, they do not use sterile technique, and although anesthetics are available, neither Kostov nor Vasilev typically use them. The Algerian nursing staff provides at least a modicum of organization and care in this dreadful environment.

At first Young approaches the situation with disbelief and anger. He then attempts to improve the quality of care, first by introducing a flow sheet for obstetrical care, and later by submitting a report on the poor conditions to the hospital director.

Mild-mannered Dr. Vasilev supports him, but no one uses the new flow sheets, and the Director considers the report a personal (and political) affront. Meanwhile, Ian Young presents the reader with a seemingly endless series of fascinating patient cases and interesting stories about hospital personnel, as well as about his excursions to various parts of Kabylia.

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