Showing 221 - 230 of 250 annotations tagged with the keyword "Medical Education"
B.D. and Ryan are completing their tour of duty in Vietnam. They are bonded to each other--"some kind of cultish remnant"--because they are the only men from the original unit who have not returned home. Unexpectedly, a new lieutenant takes command. He views the unit as undisciplined; he lacks patience and a sense of humor.
Ryan's reaction is sarcastic mimicry, which the lieutenant overhears. When challenged, Ryan responds with a scurrilous comment. This initiates a menacing, deadly interaction between them. B.D. watches this interaction helplessly. He tries to persuade Ryan: "All you have to do . . . is keep quiet." (22) But Ryan can't help himself; his mission is to make the lieutenant aware of "what an asshole he is." (21)
B.D. feels increasingly desperate, fantasizing that he will blow the lieutenant up with a grenade. When he tries to enlist help from the former unit head the latter suggests that B.D. put himself in the line of fire in place of Ryan. B.D. realizes that officers stick together, and, even worse, he feels "weak, corrupt, and afraid." (30) Soon thereafter, Ryan is killed during a routine mission.
In this remarkable book of essays, Rafael Campo explores his coming-of-age as a gay Cuban-American physician. He presents us with a series of stories illuminating his childhood and college experience, skillfully interweaving them with narratives from his life as a young physician, especially his interactions with patients dying of AIDS. We follow the author from Amherst College, through Harvard Medical School, to his medical residency in San Francisco. At each step Campo is a close observer of human character and motivation--his own and others. At each step he asks, "Who am I? Who am I becoming?"
He discovers his identity as a gay man, an Hispanic man, a poet, and, finally, as a healer--not four identities, but one. He discovers, too, the healing power of connecting with patients, the "poetry of healing," something far different from the orthodox image of the physician-as-detached-or-distanced from his patients. Though Campo rejects the concept that physicians are agents for social change ("naive," he calls it), he brings sensitivity and poetry to bear on his continued search for "some way to give."
Matthew Modine plays Joe Slovak, son of a West Coast fisherman, who goes to medical school and has a hard time adjusting. The film focuses on Joe and the members of his dissection group in Gross Anatomy. Joe, perhaps because of the proud independence of fishermen, goes through most of the film with a big chip on his shoulder, refusing to take things seriously, showing up late for dissection carrying a basketball, refusing to consider the feelings of hypothetical patients, etc., while everyone else is trying their hardest to become good doctors. He falls in love with dissection partner Laurie Rohrbach (Daphne Zuniga), but he has a hard time there, too.
When Joe's roommate David is kicked out, Joe goes home to think things over. He visits Dr. Rachel Woodruff (Christine Lahti), head of Anatomy who all along has been critical of his attitude but is now at home, incapacitated with lupus. She tells him of her disappointment in her own career ("I made doctors--people need healers.") and in him, because he has never wanted to be as good as she knew he could be. She pleads with him to commit to being a good doctor.
Switch to the group's all-nighter before finals and the sudden labor pains of the very pregnant member. They all rush off to the hospital, but don't make it, and Joe winds up delivering the baby on a table in a roadside diner (soft trumpet fanfare from the soundtrack). Between Dr. Woodruff, who dies at the end, and the delivery, Joe gets the message about commitment, and he winds up with both good grades and the girl.
A woman medical student finds herself in a hierarchical dilemma while rotating through her internal medicine clerkship. She is helping to take care of a middle-aged man who has been hospitalized for a diagnostic work-up. As a consequence of invasive procedures ordered by his physicians to determine the cause of his symptoms, the patient has suffered serious complications and is moribund. The doctors are evasive with the patient and his family, who beseech the medical student for an explanation. Even though she has been instructed by the physicians to refer all issues back to them, she follows her own convictions and tells the truth: "Your father is dying."
As a result of this "insubordination," she is called in to see the head of the department, a man of "legendary diagnostic skill" with a long tenure at the hospital. He says that he will have her dismissed, and launches into a long diatribe, making the case for a paternalistic medicine in which the patient needs to believe that the physician is omniscient and possesses quasi-magical healing powers. "Miracle, mystery, and authority," he says, are at the heart of what physicians can do for their patients and to undermine these is to do harm to the vast majority of the sick. Having made his point, he terminates the interview but reinstates the student, who, it is suggested, is so grateful (for his advice or for not being dismissed?) that she kisses him.
In his study, Professor Starr examines the evolution of the practice and the culture of medicine in the United States from the end of the colonial period into the last quarter of the twentieth century. His major concerns are with the development of authority, and the Janus image of professionalization as medicine has gained power, technical expertise, and effective modes of diagnosis and treatment and at the same time seems to be getting further from the patient.
At the time of publication, our society had finally begun to take a hard look at the impracticality and the inhumanity of continuing on the trajectory of American medicine developed one hundred years ago. Starr invites the reader to consider the impact of modern stress on the profession and, more intently, on the constituency it is dedicated to serve.
This study explores the history of physician-patient relationships, especially as it relates to the ascendancy of science in medicine. The book begins by describing traditional physician-patient relationships in the 18th century. The focus, however, is on the "modern" doctor (beginning in the 1880's) and the "postmodern" doctor (beginning in the 1950's).
The author describes the transition from modern to postmodern doctor and a corresponding transition from modern to postmodern patient. A "sympathetic alliance" between physician and patient was essentially a development of the modern period (1880's - 1950's).
Dr. Hertzler leads the reader, topically and generally chronologically, through the nature of the practice of medicine in rural America from the 1880's through the 1930's. His early narratives are those of a child observing the ravages of epidemic diseases in the face of medical futility.
The remainder of the work, divided into subject headings, is devoted to anecdotes and observations on such things as horse and buggy home visits, kitchen surgery, the proprietary hospital and physician education. Having served not only as a rural practitioner, but as a professor of pathology at academic centers and a consulting surgeon, Hertzler draws on a wide experience over a period of time known for rapid advances in basic biological science which would, near the end of the narrator's life, open the way for technological medicine as we know it today.
The narrator recalls a boyhood encounter with Rab, a majestic dog. Rab causes the lad to make friends with his master, James Noble, a simple horse-cart driver. Six years later, James brings his beautiful old wife, Ailie, to the hospital where the narrator is now a medical student. She has breast cancer and the surgeon tells her that it must be operated the following day. James and the dog are allowed to remain nearby.
Ailie endures the operation in brave silence, commanding silent respect from a lively group of students. James nurses her tenderly, but she develops a fever and dies a few days later. Shortly after her burial, he too falls ill and dies. Rab refuses to eat, becomes hostile, and is killed by the new driver.
An intern in internal medicine is frustrated by his weekly clinics; he seems unable to understand why most of his patients come to see him, why they seem happy when they leave, and wonders when he is going to have the chance to do "real" medicine, such as ordering tests and making sophisticated diagnoses. One day, he sees an elderly woman who had been worked up over the years for "heart pain" without finding a diagnosis. In the past she had seen other residents for no discernible reasons.
At this visit, the author recognizes that she seems upset, encourages her to talk, realizes that she reminds him of his grandmother. The woman reluctantly admits she has fallen in love with a younger man. The resident is respectful towards her, and recognizes the beautiful woman she had once been. He begins to realize that she has experienced much that he hasn't, and that she has much to teach him about life and about being human.
The writer, a comparative literature professor, elected to spend one full semester as an up-close observer in a medical school anatomy lab during the student dissection experience. He approached the experiment with the clearly articulated intention of writing about the lab, the instructors, the students, and their subjects. The book takes the reader dissection by dissection through the socialization process, as well as the technical content, of the class--from the first cut to the final memorial services for the cadavers at the closure of the term.