Showing 231 - 240 of 256 annotations tagged with the keyword "Medical Education"
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.
A surgical intern has participated in 86 year old Mrs. Byrnes's abdominal surgery, where extensive metastases from ovarian cancer are found. The surgeons take biopsies, confirm the diagnosis, and close her abdomen, knowing that her case is not treatable. Later that day, it falls to the intern to inform Mrs. Byrne of what they found.
The author describes how he avoided the task, finding other chores to do, appealing to the attending physician to not make him talk to the patient. The attending insists, and the author finally finds the nerve to talk with his patient. Much to his surprise, she has already suspected that she has cancer, tells him not to be upset, and assures him he did his best. The author discovered that learning to be a doctor meant being open to learning from his patients.
Richard Kraft is about as burnt-out as a fifth-year resident in pediatric surgery can be. Overwhelmed by his stint in an inner-city, public hospital in Los Angeles, he seeks to hide from the misery of his patients by avoiding any personal connection with them. Then he meets twelve-year-old Joy, an Asian immigrant trying desperately to learn the puzzling ways of her new culture. She speaks words that trigger memories from Kraft's own childhood as the son of a U.S. agent in Joy's country, and he loses his distance.
He performs surgery on a life-threatening cancer in her leg, pulling back at the last minute in an unreasonable fear that he will hurt her if he cuts too deep. The implied result: incomplete excision of the cancer and a death sentence for the child he now tries, unsuccessfully to avoid. His avoidance is repeatedly foiled by Linda Espera, the physical therapist with whom he is falling in love and who will not let him abandon the emotional needs of any of the children in Joy's ward.
In 1831 Edinburgh, Cabman John Gray (Boris Karloff) delivers a paralyzed little girl and her mother to the office of Dr. Wolfe "Toddy" MacFarlane (Henry Daniell). A body snatcher by night, Gray has a special hold over the doctor, who has lost his clinical nerve and hides in the teaching of anatomy. The earnest medical student, Donald Fettes (Russell Wade), is on the verge of abandoning medicine, but MacFarlane notices his good bedside skills with the little girl, makes him his special assistant, and initiates him into the business of grave-robbing. His wife (Edith Atwater) is opposed to this action, complaining that the student will be "ruined."
Fettes is unaware that Gray and MacFarlane narrowly missed conviction for murder in the Burke and Hare affair of 1823. Obsessed with helping the child, Fettes begs Gray to find a subject on which they can practice spinal surgery. Gray complies by "burke-ing" (murdering) a well-known street singer. MacFarlane forces Fettes to remain silent and they begin their research, but they are overheard by the servant, Joseph (Bela Lugosi), who then tries to blackmail Gray only to be "burked" himself.
The child's operation does not supply immediate results and in a fit of frustration MacFarlane murders Gray as he cries: "you'll never be rid of me." Buoyed up by the news that the child has finally begun to walk and mostly to prove to himself that he does not need Gray, MacFarlane robs a fresh grave.
On the return journey from the cemetery in a driving night rain, MacFarlane is tormented by Gray's last words; the elderly woman's corpse changes into the partially animate body of Gray. The doctor loses control, his horse breaks loose, and the carriage plunges down a bank where Fettes finds the doctor dead beside the woman's corpse.
This lively biography is a work of love based on newspaper accounts and an abundance of local anecdotes about "Doc Susie," Susan Anderson, who received her M.D. from the University of Michigan in 1907, and who maintained a single-handed rural practice in the almost inaccessible heights of the Rockies from shortly after her training was completed to 1956. She lived to tell a great many stories about arduous and ill-equipped visits to out-of-the-way sites in lumber camps and makeshift farmhouses in several feet of snow through dangerous mountain passes.
After her death at the age of 90 in 1960 her survivors added their recollections to the body of lore. An authentic hero tale about what made it worth her while to withstand tuberculosis, unreliable transportation and supplies, impoverished patients, snow, and solitude, this book may remind readers of a quality of "gumption" that is one of the still admirable aspects of the American pioneer legacy.