Showing 221 - 230 of 255 annotations tagged with the keyword "Medical Education"
This short, anecdotal autobiography begins with the author's birth in Cardiff in 1923 and ends in the mid-1960's when the author had become a successful writer and physician in London. Much of the story concerns Abse's childhood and youth. The theme is self-definition: how did it come about that, like Anton P. Chekhov, the young Dannie Abse chose to devote his life to "chasing two hares" (medicine and writing).
His lower middle-class Jewish parents, especially his father, found no redeeming social value in having a poet in the family. Influenced by his older brother Wilfred (who became a psychoanalyst), Dannie gravitated toward medicine as a career, although he almost fainted when he observed his first surgery.
When Dannie was a student in London, poetry energized his life. He published "After Every Green Thing," his first volume of poetry, while still in medical training (1949). He also met Joan, his future wife, in 1949 and they were married in 1951.
He was assigned to reading chest x-rays while serving his time in the Royal Air Force. Subsequently, Dannie took a part-time job as a civilian in the RAF chest clinic in London and began his dual career as chest physician and writer. Near the end of A Poet in the Family, Dannie describes the death of his father in Llandough Hospital in 1964.
Perri Klass, who had already written of her medical school education (A Not Entirely Benign Procedure: Four Years as a Medical Student, see this database), took notes, made dashed journal entries, and saved sign-out sheets and other written memorabilia during her internship and residency in pediatrics at The Children’s Hospital in Boston, Massachusetts. Because she is a writer, she looked at her experiences in medical training with an eye towards what stories were happening. This book then is a compendium of stories and essays (some previously published) about Klass’s pediatrics training.
Klass reflects on the difficulties of being a writer and physician: "I have been a double parasite, not only learning off patients, but also writing about them, turning the agonies of sick children into articles, using them to point little morals either about my own development as a doctor or about the dilemmas of modern medicine." (p. 297) But she also notes the benefits of writing during training: "between life at the hospital and with my family, it seemed that all my time was spoken for, and spoken for again. I needed some corner of my life which was all my own, and that corner was writing . . . I could describe the astonishing contacts with life and death which make up everyday routine in the hospital." (p. xvii)
Part of the book concerns issues of women in medicine; Klass debunks the mystique of the "superwoman"--the professional, wife and mother rolled up into one incredible ball of efficiency and perfection--with a month of laundry spilling over the floor. Klass, as a successful writer, struggles with this label and includes an essay on her experiences with a "crazy person" who anonymously and publicly accuses her of plagiarism in the midst of the stress and responsibilities of residency.
However, most of the book is about being a new doctor--the terror, the patients, the procedures, the other doctors and staff. She writes of first nights in the Neonatal Intensive Care Unit, delivery room crises, adolescents with chronic illnesses, and her struggles as a sleep and time deprived mother.
She addresses difficult issues: moral dilemmas, suffering, loss, the rape and abuse of children, children with AIDS. Throughout the book is a concern for the patient’s experience, as well as the doctor-in-training’s experience. After her first night on call caring for very premature infants she notes: "Maybe my first patient and I have more in common than I realized: we are both too immature to be out in the world, but with a lot of help, we may just make it." (p. 15)
This history of western medicine in the nineteenth century chronicles the lives of some men and women who were innovators in the field of medicine. Williams begins the book in the 1700s with the life of John Hunter and his influence on nineteenth century medical practice and research.
The book consists of 16 chapters, many of which, like the one on Hunter are biographic. For example, Williams writes of the contributions, education, and lives of Florence Nightingale, Hugh Owen Thomas (orthopedics), Marie Curie, Joseph Lister, Ignaz Semmelweis (maternal health), Patrick Manson (tropical medicine), Jean-Martin Charcot, and William Conrad Röntgen. Other chapters are more theme-oriented, such as body-snatchers, discovery of anesthesia, homeopathic medicine, blood transfusion, and medical use of spas.
Black and white illustrations, such as Mrs. Röntgen's hand in an X-ray photograph help the reader to appreciate the advances in medical knowledge in the nineteenth century.
Coulehan speaks to the cadaver (Ernest), beginning with factual observations about his damp face and beard. He then becomes confessional--in fact, by directly paraphrasing the traditional Catholic formula of confession ("Bless me, father, for I have sinned . . . "). He implores the cadaver to reveal himself, to yield the truth of his condition.
In the last stanza, the tears of conjunctival irritation (formaldehyde) become tears of sorrow "for all offenses / to the heart . . . " and "for the violence / of abomination . . . . " Cutting up a corpse is an "abomination," but one that must be accepted and transcended in order to gain the power to heal. In the end, the tears become life-giving rain on the canyon wall.
The thirty-four autobiographical essays were written while Klass was a medical student in the Harvard class of 1986. Many of her short chapters were previously published as columns in magazines, journals and newspapers. The insightful but often funny stories cover a variety of scientific and clinical subjects, lifestyle, eating habits, and relationships with other professionals, including nurses.
Pregnancy and the birth of her son half-way though training makes her experience somewhat unusual. In several other essays, including "Macho" and "Learning the Language," Klass reveals her particular sensitivity to language and the advantages and disadvantages of professional discourse.
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.