Showing 231 - 240 of 424 annotations tagged with the keyword "Professionalism"

Maimonides

Nuland, Sherwin

Last Updated: Mar-29-2006
Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Biography

Summary:

This concise and well-written biography is meant to be, as Sherwin Nuland tells us, "a guide for the perplexed," for those who may recognize the name of Maimonides and his historical importance to Jewish religion and culture, or who may even have read some of his works, but have no knowledge of the man behind the name. The story begins, as it should, in Medieval Spain with its vibrant Judaeo-Islamic culture, in which the historical relationship between Judaism and medicine developed and later expanded throughout the European and Islamic worlds. Though they were outsiders in both civilizations, Jewish physicians became the most sought after healers in the Christian and Muslim worlds.

Moses son of Maimon (also known as Maimonides and the Rambam, 1138-1204) was born in Cordoba, the cultural and political center of Muslim Spain. He and his family had to flee Cordoba to avoid persecution in 1148. They wandered through Spain until 1160, when they settled in Fez, Morocco. Again fleeing from persecution, Maimonides moved to Fustat, Egypt, when he was 30 years old and remained there for the rest of his life. During these early years, the young rabbi wrote numerous biblical commentaries, culminating in the Mishneh Torah, his great code of Jewish law. Later, he attempted to reconcile faith with reason in another great work, The Guide for the Perplexed, completed in 1190.

Maimonides's specifically medical work is difficult to characterize and evaluate. The traditional historical assessment is that he was "unique in his time in the theory and practice of medicine." Essentially, he practiced Galenic medicine, as transmitted and developed in the flourishing Islamic tradition. We don't know how he acquired his medical knowledge, but by the time he reached Fustat, Maimonides was acknowledged to be a leading physician and in 1190 he was appointed personal physician to the vizier of Egypt. Late in life, Maimonides wrote a number of medical treatises, most importantly his Medical Aphorisms, which presents a coherent, well-organized, and practical medical system based on Galen and Aristotle.

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Summary:

This collection contains all the stories in Arthur Conan Doyle's Round the Red Lamp, six additional medical tales (three of which are from the Sherlock Holmes oeuvre), and the published version of "The Romance of Medicine" (1910), an awards ceremony address to the medical students at St. Mary's Hospital Medical School.

Round the Red Lamp (see annotation in this database) received almost universally negative reviews when it was published in 1894. They deplored the fact that Conan Doyle wrote about such "nauseating" and "ghastly" topics. All but one of the stories deal with doctors, disease, or medical practice. (The exception is a gothic tale that has a medical student as its hero.)

For example, "Behind the Times" contrasts the behavior of old fashioned humanistic physicians with that of modern scientifically-oriented physicians; "The Doctors of Hoyland" conveys a very positive image of women physicians; "His First Operation" depicts a first-year medical student fainting in the operating room; and "A False Start" presents a humorous account of Conan Doyle's difficulties in starting his own medical practice.

The three Sherlock Holmes stories are "The Dying Detective" (1913), "The Creeping Man," (1923) and "The Blanched Soldier" (1926). "The Romance of Medicine" is an inspirational essay on professionalism and medical history, somewhat similar in tone to, and contemporaneous with, the essays of William Osler.

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Annotated by:
Bertman, Sandra

Primary Category: Visual Arts / Painting/Drawing

Genre: Engraving

Summary:

A doctor sleeps in a sitting position, ensconced in an enclave next to what appears to be a hearth. His head rests against comfortable cushions and he is fully clothed. A demonic figure replete with teeth, claws, and wings occupies the upper right-hand corner of the frame and holds an accordion-style fan behind the doctor’s ear.

In the painting’s foreground, a nude woman faces her body forward towards the viewer but turns her head to look at the doctor. Her right arm extends her hand, which points lazily to the hearth. A garment that covers her genitalia is draped over her outstretched arm. At the base of the image, a winged cherub plays on homemade stilts. He does not appear to interact with the other figures in the print.

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What Patients Taught Me

Young, Audrey

Last Updated: Jan-17-2006
Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

This collection of stories describes "a medical student's journey" (the subtitle) through the difficult terrain of clinical education. In Audrey Young's case, this is also a geographical odyssey from Seattle to Swaziland to Pocatello, Idaho, as she completes her University of Washington clinical rotations and electives. In one sense the main characters of these narratives are the patients the author encounters in clinics and hospitals. As she writes in the Preface, "Patients teach things that the wisest and most revered physicians cannot, and their lessons are in this book."

In another sense, of course, Dr. Young herself is the central character of these stories; this is an account of her journey into doctoring. The author first takes us to Bethel, a Yupik Eskimo town on the Bering seacoast of Alaska, where she had her initiation into clinical experiences in the form of a summer preceptorship. There she learns that patients are far different from textbook examples, as she confronts the social and cultural factors that influence illness and its amenability to treatment. We follow the author to assignments throughout the WWAMI network. WWAMI is the University of Washington's decentralized clinical training program (Wyoming, Washington, Alaska, Montana, and Idaho).

In Spokane she delivers a baby for the first time, supervised by an opera-loving attending physician. In Pocatello she takes care of her first critically ill neonate. In Missoula her life becomes "one of resigned solitude" in her internal medicine clerkship, where she experiences sleep deprivation and experiences sunlight only "through dusty windows."

During her fourth year, the author finds herself treating desperately ill AIDS patients without a supervising physician (he had gone to Zaire for a funeral and might be back the following week) and also without anti-retroviral drugs. However, it is in Swaziland that she learns the deep power and dignity of medicine, as exemplified by a patient who invites her to a dinner in her honor that requires killing one of his precious chickens.

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Leopold's Maneuvers

Davis, Cortney

Last Updated: Jan-11-2006
Annotated by:
Kohn, Martin

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

Leopold's Maneuvers is Cortney Davis's award-winning collection featuring 40 poems in two sections, in addition to the title poem. Thirty of the poems have been previously published in journals and anthologies such as Crazyhorse, Witness, Poetry, and Intensive Care. The content of the poems can roughly be divided into four categories: Nursing (e.g. "Leopold's Maneuvers," Examining the Abused Woman," "Water Story"); Domestic Remembrance (e.g. "Treatment," "The Brightest Star is Home," "When My Father's Breathing Stopped," "Everything in Life is Divided"); Flights of Imagination (e.g. "Shipwreck," "The Jar Beside the Bed"); and not unexpectedly, a Blend of the Realms in which she lives, works and dreams (e.g. "Mother's Gloves," "Confessions").

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Toccata and Fugue

Kelly, Timothy

Last Updated: Jan-09-2006
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

This collection of 20 poems is inspired by the human body. In anatomical detail these poems depict the body's beauty of structure, its rhythm of movement, its versatility of metaphor. This is not surprising, perhaps, for the work of a poet who is also a physical therapist.

In "What I Know" (p. 11) the poet helps his patient across a hospital lobby into the "breezy, sun-dotted day." She struggles with her walker, as the poet visualizes her impairment in himself, in a spiritual sense "unable to move or feel my right side." And the world's more global impairment, where each day violence is visited upon the "brave peacemakers and blessedly meek." "Tongue" (pp. 16-17) builds upon the earthy glossals, glottals and trills made by the muscles of speech to celebrate the expressive beauty of song, while remembering that the tongue is "flesh . . . first and last."

Kelly sticks closely to flesh in "Surface Anatomy" (pp. 21-22), in which he draws word-portraits of bones, including the greater trochanter of the femur, vertebral spinous processes, and patella, and in "Voluptuosity" (pp. 27-28), where he thanks God for the body's curves: "The body's curving comes / to the hand like the dry fields / rise to rain. . . "

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Arrowsmith

Lewis, Sinclair

Last Updated: Dec-19-2005

Primary Category: Literature / Fiction — Secondary Category: Literature / Fiction

Genre: Novel

Summary:

Martin Arrowsmith is from a tiny mid-western town. He goes to college and then to medical school in the largest town in the state. He begins to worship Gottlieb, Professor of Bacteriology, one of the few professors who is devoted to pure science instead of lucrative practice. Martin becomes Gottlieb’s assistant and annoys his professors and friends by constantly talking about methodology. He is engaged to Madeline, a rather dull graduate student in English. When he meets Leora, a nurse, he breaks his engagement to Madeline. Martin grows disenchanted with his career, leaves school, and wanders around the midwest. Finally, he marries Leora and returns to school. Now, however, he becomes a disciple of the Dean, Silva, whose science is much less precise and who is devoted to making people comfortable at all costs.

Martin sets up practice after graduation in Leora’s home town. The Swedish and German farmers find him invasive and unwilling to cater to their small-town expectations. When Martin misdiagnoses a case of smallpox, he is forced to leave town. He has by then found a new hero, Gustave Sondelius, who fights plagues abroad and returns to America to lecture. Sondelius finds him a job in a larger town as an assistant to Dr. Almus Pickerbaugh, Director of Public Health. Pickerbaugh writes popular poems against sidewalk spitting and alcohol but does little else. The town loves him. He becomes a senator and Martin takes over the department. He quickly makes enemies of the very people Sondelius pleased. He also returns to research. Between annoying the upper crust with his brusqueness and annoying the farmers by closing their diseased dairies, he is soon drummed out of town.

He is then hired as a pathologist at the Rouncefield Clinic, where he does meaningless, repetitive work. His old mentor, Gottlieb, saves him by getting him a position at the McGurk Institute in New York. The Institute is very rich and gives scientists a chance to work without the interruption of patients or a need for practical application. Martin returns to Gottlieb’s principles and discovers a cure for bubonic plague. The Institute, which is not free from economic interests, sends him off to the tropical island of St. Hubert to test his material and save the population.

Martin is determined to conduct a controlled trial. When his wife and Sondelius both die of the plague, however, he injects everyone, saves the island, and returns to New York. Gottlieb has dementia and can neither blame nor forgive Martin for his lack of scientific aplomb. Martin marries an heiress and briefly lives the rich life he always dreamed of, but finds that his new wife will not let him work. Finally, he joins a friend who has built a laboratory in Vermont and happily returns to research.

 

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Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Noah Praetorius (Cary Grant) is a physician who cares for patients as human beings and not just bodies. His unorthodox methods are being challenged by Dr. Elwell (Hume Cronyn), who wishes to discredit Praetorius by exposing the secrets of his past. While Elwell investigates, Praetorius cares for a pregnant, unwed student (Jeanne Crain), who on learning of her condition, tries to commit suicide.

In order to give her hope, Praetorius tells the student that he was mistaken about her pregnancy and eventually marries her. In the conclusion, Praetorius reveals to a committee his secret life, which includes the historical questionable necessity of procuring his own cadaver for anatomy study, and wins the day.

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Finesse

Faber, Michel

Last Updated: Dec-01-2005
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

A screening chest X-ray reveals the presence of a cardiac myxoma in a 72-year-old dictator. His personal physician (fearing for his own life) timidly informs Mr. President about the tumor and the likelihood that it will claim the dictator's life in a matter of months. The physician lacks the training and ability to remove the tumor but recommends Dr. Gala Sampras as the surgeon most qualified to perform the procedure.

Slight problem: Sampras was one of 14 surgeons who "disappeared" in 1992 after criticizing the dictator and his regime. She was imprisoned and abused in a labor camp. Her husband and three children were also removed from society. A bargain is struck. Sampras will do the operation. After the surgery is done, she will be reunited with her family.

The dictator shows Sampras pictures of her family. Although the photos of her children appear to be recent, the picture of her husband seems to have been taken years ago. On the day of surgery, the dictator directs the doctor's attention to the courtyard where soldiers surround her daughter. Sampras realizes the dictator might not survive the operation given the complexity of the procedure and the patient's age. Before succumbing to his anesthesia-induced sleep, the dictator is told by Sampras not to worry, but her every move is closely monitored by his soldiers. The night is likely to be long and hard for the doctor and the dictator.

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The Diagnosis

McEwan, Ian

Last Updated: Oct-04-2005
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

A neurosurgeon looks forward to having a day off from work, but a promising Saturday brings only trouble. Henry Perowne is 48 years old and practices in London. Lately, he's concerned about the impending invasion of Iraq. Perowne's views on the situation have changed considerably after conversations with a patient who was tortured and imprisoned in Iraq for no apparent reason. A protest march against the looming war is held on Saturday.

On his way to play a game of squash that morning, Perowne is involved in a car accident on an otherwise deserted street. No one is injured and the two vehicles sustain only minor damage. The owner of the other car is a man in his twenties named Baxter. He is accompanied by two buddies. Perowne refuses Baxter's demand for cash to repair the car so Baxter punches the doctor. Perowne is moments away from a pummeling.

He notices that Baxter has a tremor and an inability to perform saccades. Perowne deduces that Baxter has Huntington's disease. The doctor capitalizes on the fortuitous diagnosis. He speculates that Baxter has kept the neurodegenerative disorder a secret from his sidekicks. When Perowne initiates a discussion about the illness, Baxter orders the cronies away so that he can speak privately to the doctor. The two men desert Baxter, and Perowne escapes in his car, hopeful he can still make the squash game.

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