Showing 201 - 210 of 255 annotations tagged with the keyword "Medical Education"
Levin, a social documentary photographer, immersed herself with the Class of 2001 in the anatomy course at Weill Medical College of Cornell University. Her photographs of cadavers, students and instructors are prefaced by a foreword by physician-writer Abraham Verghese. He describes the rite of passage of anatomical dissection: "The living studying the dead. The dead instructing the living." (p. 9)
Interspersed with the full-color images are journal entries by 11 medical students and several artistic anatomic illustrations by 3 of the students. The journal entries and photographs are organized temporally, from the introduction to the dissection lab to the final exam and student-organized memorial service. The end of the book includes the interests and brief biographies of the 11 students and a final dedication by Levin of the book to those who donated their bodies: "I have never before witnessed a gift that is honored, respected, and consumed so completely."
The photographs are not for the squeamish. For example, the double amputee pelvis prosection on page 102, or the multiple images of flayed skin, bits and pieces, or limbs tied to supports provide an insider’s view of an anatomy course. Many of the images show the living in motion: translucent images of students in time-lapse swirl near the static cadavers. Other images conjure the once-upon-a-time personhood of the dead: pink fingernail polish on a female cadaver or a heart palmed by a student. The intensity of the student experience is well documented, as is the relaxed atmosphere that inevitably develops as students become accustomed to the experience of dissection.
The student journal entries are sensitive and thoughtful. Students comment on the intersections of daily living, home life, and their own bodies and bodily functions with what they are learning in the classroom. Particular discomfort regarding certain dissections, such as the pelvic region, are acknowledged. Even though students note growing immunity to the dissection experience, such comments reflect insight into professionalism and defense systems. Gallows humor and uneasiness with such humor is explored by Rebecca (p 62) after she sings "New York, New York" to the roomful of cadavers. Forensic clues about the cause of death for a particular cadaver renew the sense for students that this was once a living, feeling person.
The intense, long hours required for understanding and memorizing the material are clearly evident, but ultimately, these students realize they are given a truly special opportunity: "I began to love learning the material just for the sake of learning. Anatomy no longer felt like a burden, but rather a gift." (David, p. 119) Relationships explored include those of student with cadaver (particularly respect/disrespect, ownership and protection), life with death, and those who have had the experience of dissection with those who never will.
This is a collection of humorous sketches first published in 1850. They purport to describe the youthful experience (and antics) of an elderly "swamp doctor" named Dr. Madison Tensas. In fact, they are the work of Henry Clay Lewis, a young Jewish-American doctor who, after graduating from the Louisville Medical Institute in 1846, set up practice in MADISON County, Louisiana, along the banks of the TENSAS River.
The Introduction of this edition, written by Edwin T. Arnold, locates Henry Clay Lewis and his work within the context of 19th Century "South and Southwest Humor," and briefly discusses each piece. One of his major points is that the swamp doctor's "odd leaves" contain a dark, almost Gothic strain, thoroughly mixed in with their humorous and prankish sensibility. (Perhaps "lack of sensibility" would be a better phrase to use to describe these sketches.)
The first brief sketch compares characteristics of the "city physician" with the "swamp doctor." After this, we follow the growth and development of "Dr. Tensas" from childhood through medical school and into his practice in the swamp country of Louisiana. Among the more notable sketches are "Getting Acquainted with the Medicine," in which the student's preceptor conceals his bottle of whiskey by labeling it "tincture of arsenic"; "The Curious Widow," in which the student prepares a gristly surprise for his snooping landlady; "Being Examined for My Degree," which demonstrates the comic vagaries of oral examinations; "My First Call in the Swamp," in which the newly minted doctor cures his first patient (more or less); and "How to Cure Fits," which presents a novel and efficient treatment for hysterical disorders.
If you want to find some genuine clinical wisdom in this book, look no further than "My First Call in the Swamp," where the author observes, "if you wish to ruin yourself in the estimation of your female patients, hint that the disease they are laboring under is connected with hysterics" (p. 146).
A young doctor, recently assigned to a country hospital, is fraught with anxiety, especially over his lack of experience with obstetrical problems. One night the midwives call him; a woman is having a difficult labor. The fetus is presenting in a transverse position. The doctor must reach internally and “turn it around by the foot,” as Anna Nikolaevna, the seasoned midwife, reminds him.
The doctor has never performed this procedure. He buys time by going back to his room to consult the textbook (under the pretext of going for cigarettes). Finally, he can't avoid it any longer. He performs the rotation. It works! Both mother and baby are saved.
In his first chapbook of poems, Richard Berlin, a psychiatrist, writes about his current work with patients ("What a Psychiatrist Remembers," "Rough Air," "Berlin Wall," "Jumpology"), about his experiences on medical wards and as a student ("Anatomy Lab," "Sleight of Hand," "Alzheimer's Unit," "Obstetrics Ward, County Hospital"), about love and family and how medicine sometimes infiltrates even these sanctuaries ("How JFK Killed My Father," "Tools," "Our Medical Marriage") and, most effectively, about the complexities inherent in the role of physician and healer ("What to Call Me," "After Watching Chicago Hope," "Code Blue," "What I Love"). In other poems, he observes the human condition through the veil of medicine ("Hospital Food," "PTSD").
The lure of these poems is Berlin's facility with metaphor; he has a talent for spinning a particular image or observation into revelation. He is also willing to allow puzzlement, doubt, and fear into his poems, effectively conveying both the virtuosity of the teacher and the wonder of the student. Reading this collection, I felt as if the poet was a presence both within the poems and outside of them, like the psychiatrist who must enter the mind of the patient and, at the same time, step back and become a safe guide. It is this double vision that sets his poetry apart.
Beginning with its epigraph ("Some patients who have been resuscitated request that they not be rescued should they die again"), this poem explores several points along the boundary between life and death. The male subject is giving mouth-to-mouth artificial respiration to a female training dummy with "an ample chest."
After a while he notices the similarity of his motions to those of "the little death" (a euphemism for sexual climax). For all that, he tires and "she" "dies"--i.e., the tape (a cardiogram?) issuing from her side stops unwinding. When he tries to get up, he discovers that his leg is asleep, which prompts a final musing on the experience of being just about to die.
August is divided into two sections: "On the Corner of Fourth & Irving" and "To Marie Curie." The narrator, on a street corner in San Francisco near the teaching hospitals and medical school of University of California, San Francisco, meditates on the recurrence of lymphoma in a patient. Evening is approaching, fog blows in from the ocean, and the city pigeons are unsettled--landing and taking flight.
The meditation includes a tribute to Madame Curie and her discovery of the effects of radium. The patient had had a good chance of cure by radiation treatment--unfortunately, this patient is in the twenty percent who are not cured. The narrator, probably a physician-in-training due to the load of textbooks, had read the patient's chest x-ray as negative (normal) previously.
By the end of the poem, we learn that the physician had felt enlarged lymph nodes in this patient's neck today and he bluntly states: "I have failed. He has not been cured." The poem closes with the sound of the wind and the "beating and beating of wings."
Narrative competence is important for effective health care practice. By "narrative competence" I mean mastering a wide array of narrative skills, ranging from active listening and empathic responding in the client-practitioner interaction to reflective writing about one's professional experience. In the author's first book (The Therapeutic Potential of Creative Writing: Writing Myself, see this database), she explores the potential of creative writing as an aspect of therapy, and also presents some introductory writing skills. This book overlaps somewhat in covering the background for reflective practice, but focuses in considerably more detail on skill building.
Near the beginning of the book, Bolton presents a clear summary of "The Principles of Reflective Practice" (chapter 2). Recognizing that therapeutic writing is often accomplished in a group setting, the material on "Group Processes and Facilitation" (chapter 4), "The Creation of a Team" (chapter 5), and "Assessment, Evaluation, Mentoring and Values" (chapter 6) serves to introduce the last 100 pages of the book, which address specific writing skills, beginning with "How to Begin Writing" (chapter 8).
The author first presents an introduction and rationale for the concept of using creative writing as therapy, either self-prescribed or as part of professional treatment. She then provides practical guidelines for starting a journal (Chapter 3), and for beginning to write poetry, fiction, and autobiography (Chapter 7).
The text includes an accessible introduction to images and metaphors--aspects of the craft--as well as to methods of capturing dream material (Chapter 6) for use in one's creative writing. The later chapters present therapeutic writing in various contexts--as group work (Chapter 9), or in various institutional settings (hospital, nursing home, hospice, and prison). There are examples of therapeutic writing, especially poetry, throughout the book.
Some interesting and very odd characters (including a few scientists and researchers) inhabit the eleven short stories in this collection. In "Concerning Mold Upon the Skin, Etc.," Anton van Leeuwenhoek creates his first microscope and becomes so absorbed by the invisible worlds revealed to him that he neglects his own family. "Nowhere" is the tale of an old anatomy professor who aspires to spice up the curriculum by obtaining a corpse for his students to study. "Tumbling" recounts the difficult life of a young woman understandably haunted by the possibility that she may inherit Huntington’s chorea from her father and her inspired liberation of over one thousand laboratory mice.
In "Chloroform Jags," a professional midwife self-experiments with chloroform "not to escape time but to dissolve time." Other stories describe the execution of an elephant; the murder of a physician who happens to be an important figure in the French Revolution; a woman with a talent for insomnia who has not slept for six months; a psychoanalyst and his patient; an eighteenth century blind beekeeper; and Dorothea Dix, an early advocate for the humane treatment of the mentally ill.
Peppered with a plethora of black and white stills, this book is a compilation of a physician's film reviews and reflections on how movies have mirrored the changes in medical care and in society's attitudes towards doctors and medicine over the last sixty years. Ten chapters blend a chronological approach with a thematic perspective: Hollywood Goes to Medical School; The Kindly Savior:
From Doctor Bull to Doc Hollywood; Benevolent Institutions; The Temple of Science; "Where are All the Women Doctors?"; Blacks, the Invisible Doctors; The Dark Side of Doctors; The Institutions Turn Evil; The Temple of Healing; More Good Movie Doctors and Other Personal Favorites.
The appendices (my favorite) briefly note recurring medical themes and stereotypes ("You have two months to live," "Boil the Water!"). Formatted as a filmography, the appendices reference the chapter number in which the film is discussed, the sources of the photographs, and a limited index.