Showing 211 - 220 of 472 annotations tagged with the keyword "Medical Ethics"

Indian Camp

Hemingway, Ernest

Last Updated: Nov-28-2006
Annotated by:
Willms, Janice

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

From a fishing trip the local doctor is summoned to an Indian village to assist a woman in labor. With him are his young son and an older male relative. The physician assesses the situation in the closed, pungent hut and determines that his only option is section--with a pen knife and fishing leader as his instruments, and no anesthesia for the Indian woman. The doctor arrogantly, but only briefly, celebrates his success as a surgeon only to discover that the woman's husband, apparently unable to tolerate his wife's pain and the racism of the white visitors, has silently slit his own throat. The child, who has observed the entire proceedings asks, "Is dying hard, Daddy?"

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Summary:

This fine collection of writings by women involved in health care stems largely from a writing group cosponsored by the Nebraska Humanities Council and the Creighton University Center for Health Policy and Ethics. However, other writings also appear in this volume: in all there are 40 pieces by 16 authors. Writing genres include essay, short story, and poetry. The works are divided into three sections: Power and Powerlessness, Vulnerability and Voice, Connection and Disconnection. As noted in the introduction, these are "major themes in feminist perspectives in ethics" and the works are offered as reflections on modern ethical dilemmas in health care.

Some of the most powerful pieces are stories about being the newcomer--the student or junior trainee. For instance, "Washing Cora's Hair" by co-editor Amy Haddad is a poignant look at the struggle of two young nursing students to wash the long braids of a bed-bound elderly woman in her cramped home, and "The Story of David" by Ruth Purtilo, written as a memoir looking back to when she was a newly graduated physical therapist, concerns her interactions with a young, angry, depressed quadriplegic patient and with her superiors.

Another memorable piece is "The Things You Do" by Kelly Jennings Olsen. This story about being a new volunteer emergency medical technician masterfully controls the tensions of emergency medical care, the anguish of the father whose little girl slipped under his tractor, and the nuances of living in a small town. Several poems also deal with issues of the newcomer and witness to suffering (e.g., "As Ordered" by Ruth Ann Vogel--a poem about shaving the head of a neurosurgical patient on the pediatric ward)

As noted by the multiple keywords listed above, these pieces touch on many topics. Power relations play a key role, both between professionals and between patient and the health care team. For instance, in the polished story, "Procedures" the author Kim Dayton writes from the perspective of a young single mother with a critically ill neonate. This mother is repeatedly prevented from visiting her child because of "important" events like rounds and procedures, and she ironically only gets to hold her baby after the baby dies.

Throughout the collection the patients are described with honesty and vividness. Their suffering can haunt the health care worker ("Maggie Jones" by Veneta Masson) as well as teach ("Back to Square One" by Barbara Jessing). Many of the pieces remind us of our good fortune and the privilege we have in our lives and in providing health care services (e.g., "Spring Semester" by Amy Haddad). Ultimately in this volume our common humanity is emphasized--the connections between people and the remarkable grace that can be exhibited in the face of suffering.

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Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

This haunting memoir by a South African surgeon who has witnessed tremendous suffering across the globe is best read as his story, and not a war chronicle as the subtitle would suggest, since large chunks of the book are not about war in the dressing station sense of the term. That said, however, the war that rages inside the author continues throughout the book and gives the reader glimpses of wisdom gained during Kaplan's remarkable journey of life amidst death. The book is culled from journals of writing and sketches that he kept throughout his travels.

Kaplan's first crisis occurs when he joins fellow medical students in an anti-apartheid demonstration in Cape Town and, following the lead of a more senior student, Stefan, tends to the wounded and frightened after riot police attacked the demonstrators. Kaplan then gets the call of not only medicine as service, but surgery as service, when, as a neophyte doctor, he saves the life of a youth shot in the liver by the police.

This feat should not be underestimated, though the author writes with humility. Indeed, in recounting later incidents in which patients die, the odds tremendously stacked against the patients surviving anyway (a woman with disseminated intravascular coagulopathy and multiple organ failure, or the Kurdish boy in a refugee camp with a great hemorrhaging, septic wound), the author's self-chastisement is a painful reminder of how the physician suffers with each loss.

After a beautifully written prologue which begins, "I am a surgeon, some of the time" (p. 1), the book proceeds chronologically, each chapter named for the location of the action. Kaplan leaves South Africa to avoid military service and the fate that befell Stefan, who becomes an opioid addict after euthanizing a torture victim in a horrible scene of police brutality and violence. Kaplan's post-graduate training in England and BTA (Been to America) research stint heighten his sense of cynicism about hierarchy in English society and capitalistic forces in American medical research.

Ever the outsider, Kaplan first returns to Africa (treating victims of poverty, deprivation and violence), then sets off to war zones in Kurdistan, Mozambique, Burma (Myanmar), and Eritrea. In between, he works not only as a surgeon, but also a documentary filmmaker and a cruise ship and flight doctor. He avoids the more established medical humanitarian relief efforts, such as Médecins Sans Frontières, and instead prefers to work where no other ex-pat physician will go--enemy territory, front lines, and poorly equipped dressing stations.

Along the way he decides the number of people he has helped as a surgeon, particularly in Kurdistan, has been small compared to the potential to intervene in broader public health measures (he meets a Swiss water treatment engineer) and occupational health exposés to help abused victims (e.g., of mercury poisoning in South Africa and Brazil). The book ends with Kaplan studying to become an expert in occupational medicine, though, incongruously, in the heart of London's financial district where he treats stress-related illness.

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Annotated by:
Sirridge, Marjorie

Primary Category: Literature / Literature

Genre: Collection (Mixed Genres)

Summary:

The first sentence of the introduction indicates the author's intention to talk about "how we do it--and how we could do it". Ending life, she says, is an issue under sustained debate in the United States and in much of the developed world. The argument over physician-assisted suicide is the central framework. The described debates on euthanasia and suicide include two pro and three con arguments in American and international contexts. This collection includes essays, practical notes, historical explorations, policy analyses, fiction, and creative non-fiction written by the author.

The author describes the role of fiction and creative non-fiction as offering a recognition of narrative as a respected form of investigation of social issues. Included are two selections that are in this genre and they are very powerful. The essay on the ethics of self-sacrifice is timely and well written. The author's final conclusion is that Stoic and Christian thinking are still in active collision in much of our consideration of these issues and that this means that advance personal policy making remains in the fullest sense an exercise for each individual.

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Annotated by:
McEntyre, Marilyn

Primary Category: Performing Arts / Film, TV, Video

Genre: Video

Summary:

This film tells the remarkable story of Vivien Thomas (played by Mos Def), an African-American fine carpenter, who found his way into medicine through the back door and changed medical history. Hired when jobs were in short supply to work as a custodian and sometime lab assistant to Dr. Alfred Blalock (Alan Rickman), a research cardiologist, Thomas quickly becomes an irreplaceable research assistant. His keen observations, his skill with the most delicate machinery and, eventually, in performing experimental surgery on animals, make clear that he has both a genius and a calling.

Though the relationship has its tensions (Blalock, as a Southern white man and a doctor, has some blind spots in the matter of mutual human respect, though he highly values Thomas’s skills) it lasts for decades. The two move their families to Baltimore, where Blalock becomes Head of Surgery at Johns Hopkins and, much to his colleagues surprise and to some of their dismay, brings Thomas in to perform groundbreaking open heart surgery on a blue baby. It is not until after Blalock’s death that Thomas is granted an honorary doctorate from Johns Hopkins, where he continues to work in research until his own retirement.

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An Acquaintance with Darkness

Rinaldi, Ann

Last Updated: Oct-16-2006
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel for Young Adults

Summary:

The novel is set in Washington, DC in April, 1865. At fourteen, Emily is sole caretaker of her mother who is dying of tuberculosis. Her neighbor, Annie Surratt, is her best friend, though their mothers have been estranged for some time. Both families have deep roots in the South. Annie’s brother, Johnny, an object of Emily’s romantic fantasies, has recently left on a secret mission. The war is nearly over. Emily’s uncle Valentine, a physician, wants to take custody of her after her mother dies, but because her mother has also felt estranged from him, Emily resists. Still, after her mother’s death, she does go to live with her uncle, and learns that he (with his two assistants, one of whom is a woman who is 1/8 African American) has a lively practice among the poor and the African Americans who have flooded the streets of Washington since the emancipation.

Valentine is called to Lincoln’s bedside the night of his assassination, and participates in efforts to track down John Wilkes Booth and his accomplices, one of whom appears to have been Johnny Surratt, who has escaped to Canada. In the course of her time there Emily discovers that her uncle and his assistant are involved in elaborate, marginally legal, schemes to obtain bodies for study at the medical college. Emily, at first horrified by this discovery, comes to recognize the good that comes of anatomical studies and to sympathize with her uncle’s efforts to bring about legislation making the acquisition of bodies for medical research easier. Annie’s mother is hanged as an accomplice in the Booth conspiracy, Annie leaves town, and Emily comes to understand a great deal more about the harsh terms on which life must be lived in times of national crisis and ideological warfare. The story ends with her growing interest in medicine as a possible career path.

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Ripe

Jacobstein, Roy

Last Updated: Oct-12-2006
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

This is the first full-length collection by pediatrician and international health physician Roy Jacobstein. These 40 poems engage a wide range of topics, settings, and tones, but all demonstrate the same fine craftsmanship and strong voice.

Among the most engaging of Jacobstein’s poems are those dealing with memories of childhood and adolescence. Consider, for example: “Mr. Gardner in 10th grade told us there was no purpose / to mitochondria, only function.” (“Atomic Numbers,” p. 5). Or, “What transgression made fat Mr. Handler / drop his towel, his gloves, everything… to chase you from one end / of Fullerton to the other?” (“The Lesson,” p. 30) The poet displays a delightful sense of humor in pieces like “Bypass” (p. 36) and “Squid’s Sex Life Revealed in USA Today” (p. 59). Poems with explicit medical themes include “Pre-Med” (p. 6), “Admissions” (p. 8), and “What It Was” (p.11).

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How To Be Good

Hornby, Nick

Last Updated: Oct-06-2006
Annotated by:
Henderson, Schuyler

Primary Category: Literature / Fiction

Genre: Novel

Summary:

This novel is narrated by Katie Carr, who very much wants to be a good person.  She is a physician and a mother of two, and lives with her petulant husband, David.  David is the author of a column in the local newspaper called "Angriest Man in Holloway".  As their marriage falls apart, David undergoes a conversion at the hands of GoodNews, a young guru, and ceases to be sarcastic and angry, embarking instead on an effort to improve the world with acts of kindness.  Katie is forced to consider what it means to be a good person and how that affects whether to salvage her marriage, how to raise her children and how to be the type of physician she always considered herself to be.

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Never Let Me Go

Ishiguro, Kazuo

Last Updated: Oct-06-2006
Annotated by:
Henderson, Schuyler

Primary Category: Literature / Fiction

Genre: Novel

Summary:

It was valuable to me that the friend who recommended this book also suggested that I avoid any hint of its content (including the Library of Congress's classifications on the title page), advice I would pass on to anybody scanning this before reading the novel.  Set in England, in the 1990s, this is the story of Kathy H.  She is currently a carer, providing support for donors at various stages in the donation process, before eventually becoming a donor herself.  As she travels across England to the different sites where her donors are recuperating, she thinks back to her schooldays and her friends, Ruth and Tommy.

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Annotated by:
Duffin, Jacalyn

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

The young pathologist David Coleman (Ben Gazzara) arrives to join a hospital pathology lab. He encounters disorganization and a hostile, cigar-smoking chief, Joe Pearson (Frederic March), who declares his intention to keep working until he dies. Coleman tries to implement a few changes, but his suggestions are overruled.

The film revolves around two cases: possible erythroblastosis in the child of an intern and his wife whose first child died; possible bone cancer in Coleman's girlfriend, student nurse Kathy Hunt (Ina Balin). The infant's problem is misdiagnosed due to Pearson's refusal to order the new Coombs' test recommended by Coleman; the baby nearly dies, alienating the obstetrician (Eddie Albert), a long time friend who now presses for Pearson's dismissal.

Coleman disagrees with Pearson, who thinks that Kathy's bone tumor is malignant, but he opts for professional discretion, defers to the chief, and urges her to have her leg amputated anyway. He discovers that Pearson had been right: the surgery, which he thought unnecessary, has provided her with her only chance of survival. Just as Coleman realizes the enormity of his error, he learns that Pearson has resigned and that he will take over the lab.

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