Showing 241 - 250 of 474 annotations tagged with the keyword "Medical Ethics"

Annotated by:
Ratzan, Richard M.

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

This posthumously published short (132 pp) collection is by a former New York Times book reviewer and essayist who was diagnosed with metastatic prostate cancer in 1989 and who died the following year. Broyard responded to his illness by writing about the experience. The book is comprised of six parts:

Part 1: Intoxicated by My Illness

Part 2: Toward a Literature of Illness

Part 3: The Patient Examines the Doctor

Part 4: A Style for Death: Journal Notes, May-September,1990

Part 5: The Literature of Death

Part 6: What the Cystoscope Said

Parts 1, 2 and 5 appeared in slightly different form in the New York Times between 1981 and 1990.

Parts 2 and 3 are in part from a talk Mr. Broyard gave at the Univ. of Chicago Medical School in April 1990. Part 6 is a short story written by Broyard in 1954 about his father’s death.

Mr. Broyard had long been fascinated with death and dying, before his prostatic cancer, publishing "What the Cystoscope Said" in 1954, some 35 years before his own diagnosis. It is as though he had been preparing for what he knew would be his finest work. Always an engaging essayist and reviewer, Mr. Broyard here offers what he did best--a discursive (in the best sense) soliloquy on disease, suffering, the majesty of the educated, reflective person with illness--all amplified with widely ranging withdrawals from the broad literary bank account one would expect of a professional reader and reviewer: one reads about personal fate vis-à-vis D. H. Lawrence’s Women in Love; one reads, as one can read nowhere else, about illness, dying and sexuality and its relevance to Hemingway’s The Sun Also Rises.

Part 1, Intoxicated By My Illness, is a personal statement about the effect of this illness on Broyard’s attitude and is rich with his own and others’ literary sense of how he should and did react to it. Part 2, written later than Part 5, deals with literature and illness as opposed to the emphasis on death in Part 5. Within Part 2 are references to Susan Sontag, Norman Cousins and Siegel, among other students of this subject. It is interesting to compare the more powerful and personal and moving appeal of the later writings on illness (Part 2) to the more abstract, critical ruminations on death (Part 5) at a time when, in fact, Part 5 was a literary exercise. Part 2 is written with the pen of the heart.

Part 3 is a wonderful account of Broyard’s first meeting with his personal physician. While Broyard analyzes this man, he reflects on what he would like in his ideal doctor. Part 4 is a brief (7 pages) collection of short diary entries reminiscent of Dag Hammarskjöld’s Markings. Part 5 includes essays on death and dying in literature and what these books, e.g., Robert Kastenbaum’s Between Life and Death and David Hendin’s Death as a Fact of Life and Ernest Becker’s Denial of Death, have to offer us.

Part 6 is a short story about his father’s death, the son’s sexual escapades and the relationship between the two. Clearly sex, death and their nexus have long been on Broyard’s mind. This is a welcome reflection and is of interest more as it compares to Broyard’s later writings on the subject, especially in Part 2, than for its intrinsic worth as a short story.

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An Instance of the Fingerpost

Pears, Iain

Last Updated: Aug-29-2006
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

A mystery, set in the seventeenth century and told by four different eye-witnesses, all men. Two are the views of fictitious characters, two are imputed to be real figures from the past. Beautiful, but poverty-stricken Sarah Blundy is accused of having killed a professor, only remotely connected to her. Each of the observers reasons his way to a position on her guilt or innocence based on their skewed observation of the events, and on their own assumptions about women, religion, and justice. Post-Cromwellian tensions between Catholics, Protestants, and Quakers are explored.

A manuscript by the Italian, Dr. Cola, constitutes the first account. In the thrall of medical science and the great Robert Boyle, Cola is cast as the true "inventor" of transfusion which is "stolen" by the real and vibrant Richard Lower, generally credited by historians with its first use in England. Cola attends Sarah’s ailing mother gratis and transfuses her with modest success.

The other three writers react to his version of the tale which they read in manuscript. The mad Jack Prescott is intent on exonerating his probably inexonerable father for misdeeds in the Civil War, while the uncharitable cryptographer, John Wallis, is intent on divining nothing but evil in the cryptic forms of women, Catholics, and foreigners. Their versions are wondrously convoluted attempts to keep the impossible within the realm of the plausible. Pears puts the truth (such as it is) in the words of the real antiquarian, Anthony Wood, who explains that a fingerpost--like a pathognomonic sign--points to the only solution possible.

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Joshua, Son of None

Freedman, Nancy

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

Primary Category: Literature / Fiction

Genre: Novel

Summary:

A surgical resident named Thor Bitterbaum happens to be in attendance when the fatally wounded President John Kennedy arrives at Parkland Hospital in Dallas. He immediately remembers the work of a scientist who had performed some successful cloning experiments. In the twinkling of an eye, he locates a liquid nitrogen container and freezes a sample of the President’s tissue. He then locates G. K. Kellogg, a multimillionaire who is willing to foot the bill to clone President Kennedy. Kellogg’s plan is to reproduce the major events of Kennedy’s life so that his "son" has essentially the same experience as JFK and grows up to be elected President of the United States.

Not surprisingly, some things go wrong with the plan, but, in general, the whole bizarre scheme works out as G. K. and "Uncle" Thor intend it to. Joshua Francis Kellogg, the cloned child, eventually learns his origin, rebels against his "father’s" plan, blows his cover by writing a book about his experience, but ultimately becomes a successful politician just as G. K. had envisioned.

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A Blue Ribbon Affair

Selzer, Richard

Last Updated: Aug-28-2006
Annotated by:
Ratzan, Richard M.

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Bertie Shields, a second year college student, and Joyce Renfrew, a nurse, are conveying the body of a dead elderly woman to the morgue. After a brief lustful look at Joyce, whose plumpness does not go unnoticed or uncommented upon by either Selzer or Bertie, the latter averts his eyes to the leaner cadaver, going from "pubic woolgathering" to ribbon-spotting; for he notes with increasing meditative pleasure that the corpse is wearing a bright blue ribbon, tied in a small bow and sitting "at the side of her head like a butterfly." (p. 122)

Bertie waxes reflective, wondering who put the ribbon in her hair and when. Joyce, who looks thirty-five to Bertie and who has "heard about" Bertie from "one of the other girls", begins making verbal and then physical advances as they approach the morgue. Just as he has put the unnamed cadaver on her tray and is proleptically about to "slide the tray home," Bertie’s last sight of the cadaver as she is entering "the dark recess" is the "winky blue . . . "--a sight that goes unfinished as he feels Joyce’s hand on his buttocks. The inevitable happens, of course, on the now vacant stretcher.

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Dirt Cheap

Miller-Lachmann, Lyn

Last Updated: Aug-28-2006
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Nicholas Baran, a one-time student activist, is now in his 40s, teaching at a community college in rural Connecticut after having been denied tenure at an Ivy League school. The tenure denial, despite consistent teaching awards and high performance was clearly politically motivated and instigated by a right-wing professor protecting his turf and the school from a labor-oriented, media-challenging progressive. Nicholas has leukemia, and, upon noticing that he appears to be living in a cancer cluster, begins a private investigation of the large chemical company located just upstream on the river that runs through the town near his neighborhood.

The investigation becomes more intense after he comes upon a local rescue squad retrieving the body of a small boy who has drowned in the river, but whose body reveals effects of considerable acid in the water. Though his wife fears for him and resists his efforts, even to the point of temporarily allying herself (and engaging in a dailliance with) a powerful local real estate broker, Nick finds an ally in his son's teacher, hesitant, but committed to finding out the truth.

Though Nick's disease is progressing rapidly, he and Sandy, the teacher, manage to break into the company's files and retrieve enough damaging evidence to expose deliberate deception of the public as well as documenting the high incidence of cancers in the immediate neighborhood. Before his death Nick manages to supply enough material to the major media to expose the scandal, and leaves a hard-won legacy of truthtelling to his children.

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Annotated by:
Bertman, Sandra

Primary Category: Literature / Literature

Genre: Anthology (Mixed Genres)

Summary:

This unique "miscellany" of prose from journals and essays, poems, stories, music, paintings (reproduced in black and white), drawings, and cartoons illustrates countless ways that medicine and the arts, in tandem, "stretch the imagination, deepen the sympathy . . . enrich the perceptions" and give sheer, unadulterated pleasure. Organized by Robin Downie, renowned Professor Emeritus of Moral Philosophy at Glasgow University, the anthology is grouped in eight categories: "The Way We Are," "Disease and Mental Illness," "Doctors and Psychiatrists," "Nurses and Patients," "Healing," "Last Things," "Research," and "Ethics and Purpose."

Excerpts include the classic lore [Charles Lamb’s essay, "The Convalescent"; Florence Nightingale’s diary, "Notes on Nursing"; W. H. Auden’s poem, Musee des Beaux Arts (see this database); Theodore Roethke’s poem, In a Dark Time (see this database); C. S. Lewis’s journal, A Grief Observed (see this database); Sir Luke Fildes’s painting, The Doctor (see this database)] and refreshingly new nuggets from John Wisdom’s radio talk, "What is There in Horse-Racing" ("For a game of croquet is not merely a matter of getting balls through hoops, anymore than a conversation is a matter of getting noises out of a larynx,"); Robert Pirsig’s treatise, "Zen and the Art of Motorcycle Maintenance"; physician Roy Calne’s tender sketches of his own patients; composer Richard Wagner’s letter, "Biscuits as Therapy"; Janice Galloway’s novel, "The Trick is to Keep Breathing"; and expressions by patients and artists who happen to be patients of their particular illness experiences.

Lest "commentary be intrusive," except as brief introduction to each section, Downie deliberately omitted them, placing illustrations and extracts so as to provide commentary on one another. (Readers cannot help but be stimulated, however, to rearrange and create their own juxtapositions.)

The section on "Healing" considers not only the expected operations, spiritual healing, traditional cures, music and art as therapy, but also "spells, hope, and mothers." Richard Asher’s essay on why medical journals are so dull (British Medical Journal 23 Aug. 1958), or on whether or not baldness is psychological, and the comic strips of Posy Simmonds (the double entendres of "Medical Precautions," the "Minor Operation" burlesque on Shakespeare’s "All the Ward’s a Stage,") remind us yet again that birthing, aging, illness and dying are not pathological events or mere medical processes, and that the arts and humanities are bountiful reservoirs of moral discourse, inspiration, and renewal.

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The Hasty Heart

Patrick, John

Last Updated: Aug-24-2006
Annotated by:
Ratzan, Richard M.

Primary Category: Literature / Plays

Genre: Play

Summary:

Written in 1944 and first staged on January 3, 1945 with Richard Basehart and Anne Burr and Earl Jones as Basuto, The Hasty Heart grew out of the playwright’s experiences in an ambulance unit on the Burma front in World War II. The play was made into a movie in 1949 (with Richard Todd and Ronald Reagan) and was revived on Broadway in 1984.

The Hasty Heart concerns, initially, six characters in a British General Hospital in the rear of the Assam-Burma front: a nurse (Sister Margaret--"Sister" is a British term for a nurse; she is not a religious--and five Allied patients: Kiwi (a New Zealander), Tommy (a Brit), Digger (an Australian), Yank (an American), and Blossom (an indigenous Basuto) who understands and speaks no English, an important fact for later developments in the play.

Patrick introduces us to Sister Margaret and the five original patients who are, for all their good-natured bickering and nationally directed gibes, clearly a cohesive unit characterized by the camaraderie of an in-patient ward with residential patients. For instance, Tommy, who is chronically kidded about his obesity, claims to be proud of it and accuses Digger of being jealous about Sister Margaret’s giving Tommy therapeutic back rubs.

Enter Colonel "Cobwebs," the medical officer. He solicits the group’s help and cooperation in keeping a new patient "contented." It seems the Colonel has just successfully removed a patient’s kidney damaged by shrapnel only to discover that the soldier’s remaining kidney is "defective." The wounded soldier, Lachie, a Scottish Sergeant, will therefore die in only six weeks of uremic poisoning. The Colonel has "decided against telling him" since "[W]orry won’t help him."

The Colonel tells the men and Sister Margaret that "The only help anyone can give him now, [sic] will come from you." When Yank asks, "And he thinks he’s well, sir?" the Colonel replies, "In a sense--he is. But it would be criminal to release him just to collapse up forward. Do what you can to keep him contented--and happy."

With the arrival of Lachie, an incredibly difficult, abrasive and unfriendly Scot with pathological chips on both shoulders, the scene is set for "an archetypal story about friendship under fire." [Mell Gussow as quoted in a 1984 NY Times review in the obituary above, op. cit.] Despite all their earnest attempts at striking up a friendship, the other patients find themselves rebuffed, often quite rudely, by Lachie. Eventually, at the insistent urging of Sister Margaret, they are successful. A birthday gift of a complete Scottish highlander outfit touches Lachie who admits that he’s never had friends and is, to no reader’s deep surprise, a truly lonely man.

Near the end of the play, the Colonel, following orders, tells Lachie his diagnosis and prognosis, and his superiors’ desire for Lachie to return home, despite his wishes to remain with his friends, in order to become a military hero to be honored before his death. Lachie understandably retreats into a shell of resentment, blaming the men for treating him with pity instead of friendship. Eventually things right themselves and the play ends happily.

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Heredity

Davidson, Jenny

Last Updated: Aug-24-2006
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Elizabeth Mann, the daughter of a world famous fertility specialist whom she despises, hasn’t quite made it into medical school. She runs away to London, where she can revel in an orgy of self-destructive behavior, while working as a freelance writer for a travel guidebook. She soon develops two obsessions. In an obscure medical museum she encounters the skeleton of Jonathan Wild, a famous 18th century criminal who met his death by hanging. During the same museum visit, she runs across Gideon Streetcar, a young fertility specialist who once worked with her father. Though Gideon is "happily" married, he and Elizabeth soon begin a torrid affair.

Elizabeth’s obsession with Jonathan Wild grows when, through Gideon, she obtains a copy of the criminal’s second wife’s memoir. Through it, she learns that his first wife, who died in childbirth, was named Elizabeth Mann. She develops a scheme to obtain DNA from Wild’s skeleton and use it in association with an experimental cloning procedure to become pregnant with the 18th century criminal’s child (clone).

When the 25 year old Elizabeth reveals that her father tied her tubes when she was 16, after having aborted her fetus--a "slut," he called her--Gideon agrees to attempt in vitro fertilization with her eggs and his sperm. He transfers two blastocysts, plus one of the supposedly cloned Jonathan Wild cells. She becomes pregnant. Soon thereafter she returns to the USA when her father has a massive heart attack and she, apparently, has an opportunity to go to medical school.

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Summary:

This collection of sixteen Chekhov stories brings together in one volume many of Chekhov’s finest tales about doctors. The chronologically-arranged collection includes the famous novella, Ward 6, as well as such shorter classics as An Awkward Business and A Doctor’s Visit. In all sixteen stories, the doctor is a major figure, often at the center of a moral conflict.

Robert Coles , in his thoughtful forward, notes that Chekhov raises the "big questions" about "the meaning and purpose of life and the manner it ought to be conducted (and why)." Himself the editor of William Carlos Williams’s doctor stories, Coles recognizes and honors the comparison between Chekhov’s and Williams’s works and their dual careers as physician-writers. Jack Coulehan, in his introduction and comments, provides interesting biographical information on the great Russian writer as well as insightful interpretations of each story.

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Doctors' Wives

Slaughter, Frank

Last Updated: Aug-23-2006
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Novel

Summary:

The story takes place in the town of Weston, the site of Weston Medical School, with its teaching hospital and private faculty clinic. The main characters are a group of seven men (six physicians and one administrator) who met while serving together in the Army during the Korean War and later joined to form the nucleus of Weston Medical School. These men all occupy prestigious positions as chiefs of various clinical departments and conduct lucrative private practices at the clinic.

Their wives meet regularly in what they call the "Dissection Club." While the women are said to be friends, their meetings consist primarily of backbiting, cattiness, and expressions of profound boredom. Mostly, they are bored with their sex lives. While the wives generally engage in small-scale infidelities (including a medical student in one case), Lorrie Delman, the wife of the biochemist, is exceptional because of her voracious sexual appetite, about which she is highly vocal. Lorrie obsessively "sleeps around." In fact, she proposes that the group devise a regular sequence of husband swapping, a suggestion that her friends vote down in favor of a more random approach to adultery.

The drama commences when Mort Delman catches his wife in bed with Paul McGill, the dermatologist. Delman shoots a single bullet that goes through Lorrie's back and chest, killing her (she is lying on top of Paul) and then lodges in her lover's heart. Marissa Feldman, the brand new female physician, accurately diagnoses and treats Paul's life-threatening cardiac tamponade in the emergency room, after which Anton Dieter, the cardiac surgeon, removes the bullet lodged in the victim's right ventricle. Needless to say, Paul McGill recovers uneventfully, and Drs. Feldman and Dieter engage in a sexual escapade.

Meanwhile, members of the "Dissection Club" begin to re-assess their lives and loves. After all, they conclude, any of their husbands could have been caught at Lorrie Delman's house having some "afternoon delight." Perhaps the wives should pay more attention to their husbands, or otherwise enhance the meaningfulness of their lives. While this is going on, Mort Delman, the biochemist-killer, has no fear of languishing in jail because he has a perfect "impassioned husband" defense. In addition, he also manages to pull off a scheme to extort money from the other physicians in return for his leaving town and not revealing everyone's secrets. If this isn't enough to whet your appetite, Doctors' Wives also features additional plot twists and a surprise ending.

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