Showing 261 - 270 of 487 annotations tagged with the keyword "Art of Medicine"

Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

This remarkable book takes the reader into a Dutch nursing home where many of the 300 patients are terminally ill. The main protagonist is Anton, a competent, tough, and compassionate physician who tries to discover some meaning in the suffering of his patients, while at the same time disavowing any such meaning. Anton’s colleagues include Jaarsma, a somewhat detached and bureaucratic older physician, and Van Gooyer, a young physician who still believes that science has all the answers.

The first-person narrative consists of short, punchy segments (almost like an endless series of discrete physician-patient interactions) detailing the stories of Anton’s patients and his reactions to them. Many of these persons request assisted suicide or euthanasia. Anton reveals what he feels about these requests, how he goes about judging their validity, and the manner in which he actually carries out assisted deaths. A strong spiritual theme permeates the book; while Anton denies the relevance of God and religion, he seems constantly to be searching for a spirituality that "makes sense" of contemporary life.

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Annotated by:
Belling, Catherine

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

This film traces the shared career and dissolution of Beverly and Elliot Mantle, male identical twins (both played, thanks to seamless special effects, by Jeremy Irons) who are gynecologists, running a successful fertility clinic in Toronto in the 1980’s. They share both work and personal lives; Elliot, the dominant twin, lectures at the hospital, accepts awards, plays the smooth professional--and seduces women. Beverly, the quiet one, sees patients, does research--and sometimes has affairs with women his brother passes on to him.

They usually draw the line at patients, not because of ethics, but because "it’s not safe." Their dealings with women have to be carefully compartmentalized, for the ambiguous intimacy of the gynecological doctor-patient relationship is difficult and dangerous for the twins, who form a psychologically unstable and deeply interdependent relationship on their own, likening themselves to the original Siamese twins, Eng and Chang, whose names they eventually take on, too.

Their symbiotic system is disrupted when a television actress, Claire Niveau (Genevieve Bujold), consults them about her infertility. She has a trifurcate uterus--the twins call her a "mutation"--and will never have children. Elliot, fascinated, seduces her, and then gives her to Beverly, who falls in love, with disastrous consequences. When Claire discovers that they’ve deceived her and temporarily leaves, Beverly becomes addicted to the amphetamines and sleeping pills that Claire habitually abuses.

The drugs impair his work, he begins to hurt patients, is hospitalized, and after a calamitous breakdown in the operating room (where Beverly attempts to use the monstrously beautiful surgical instruments he designed himself

"for operating on mutant women") both brothers keep their hospital privileges only on condition that they don’t use them. Elliot tries to rehabilitate Beverly, but realizes that the need to do so comes from their absolute interdependence--they might as well be physically joined. So Elliot begins taking drugs as well, and when Claire returns and Beverly goes back to her, Elliot breaks down completely.

The rest of the film traces Beverly’s failed attempt to become a separate individual. The instruments he invented are now, he says, "for separating Siamese twins," and, in a terrifying surgery scene, the drugged Beverly "operates" on his conscious though equally drugged brother, apparently disemboweling him. Next morning, Beverly leaves the apartment where his dead brother lies and calls the woman he loves, but he cannot talk to her. He goes back, his bid for independent identity a failure, and the film ends on a shot of the two, dead, in an embrace echoing the Renaissance anatomical illustrations of in utero twins which illuminate the film’s opening credits.

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Doctor Zhivago

Pasternak, Boris

Last Updated: Aug-09-2006

Primary Category: Literature / Fiction

Genre: Novel

Summary:

This complex novel is difficult to summarize. The main characters are introduced separately. We meet Yurii Andreievich Zhivago (Yura) when he is ten, at his mother’s funeral. He goes on to study medicine, write poetry, and marry a young woman named Tonya. We first encounter Larisa Foedorovna (Lara) as the adolescent daughter of a widow who has been set up in a dressmaking business by Komarovsky. Komarovsky later harasses and seduces the young woman. In her anger and guilt, the impulsive Lara tries to shoot Komarovsky at a grand Christmas party, but she misses and inadvertently wounds another man. Subsequently, Lara marries Pavel Pavlovich (Pasha), her childhood sweetheart.

All this takes place against the background of social upheaval in pre-World War I Russia. When the war begins, Yura joins the Army medical corps. Pasha leaves Lara and their daughter Tanya to enlist in the army. When Pasha is reported lost behind enemy lines, Lara becomes a military nurse in order to search for him. Thus, Lara and Yura meet at a hospital where his wife Tonya has just delivered a baby boy. Lara and Yura feel attracted to one another, but neither one expresses it. At this point the Revolution breaks out in Petersburg.

As the fighting rages, Lara and Yura are posted to a hospital in a small town, where Yura struggles with his feelings. When he reports his friendship with Lara, Tonya assumes incorrectly that they have become lovers. Over the winter there are food shortages and the threat of a typhus epidemic. As the war ends, Yura returns home to Moscow, and to his old job at the hospital, but his co-workers are suspicious of him. Influenced by Bolshevism, they dislike his use of intuition instead of logic. The family resolves to travel to the Urals. Amidst Marxist rebellions, Yura's family finds room in a cargo train. During the long train ride, Yura reflects on the suffering of peasants and prisoners caused by the revolution. He shares the desire for equality and freedom, but is disenchanted by the revolutionaries' pedantic, insensitive opinions.

The family safely arrives in the Urals and set up a farm. During the long winters, Yura returns to writing poetry. While visiting the local library, he re-encounters Lara. They begin an affair, sharing a common joy in a fully-lived existence. Lara is aware that her husband is still alive, having become a feared member of the Red faction under another name (Strelnikov). Yura resolves to tell his wife about his unfaithfulness and to ask forgiveness, but as he rides home, he is kidnapped by a faction in the Civil War (the Reds) and forced to serve as their doctor.

After some years, Yura escapes from the Reds and walks back to find Lara, who still lives in the same place.  To escape being informed upon, Lara and Yura flee to the farm house where Yura and his family once lived. Again, Yura turns to his poetry, expressing his fears, courage, and love for Lara. He learns that Tonya and a new baby daughter have been deported from Russia. One night, Lara's old lover, Komarovsky, appears and tells them that the triumphant revolutionaries know where they are and will inevitably kill them both. He offers to take them abroad, where Yura could rejoin his family. Yura refuses to accept help from Komarovsky. To save Lara's life, though, he tells her that he will follow them out of the country, but actually remains behind. Alone, he turns to drink.

One night Lara's husband, Strelnikov (Pasha), who is fleeing the new government, arrives. When he learns of Yura and Lara’s love, he leaves the house and shoots himself. Yura then goes to Moscow where he strikes up an affair with Marina and becomes a writer of literary booklets.  His brother finds him a job at a hospital, but on his way to his first day at work, he dies, presumably of a heart attack. Lara, who had been living in Irkutsk, has returned to Moscow and wanders accidentally into the house where his body lies waiting for burial. After several days, Lara disappears, presumably captured and sent to a concentration camp.

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Mercy

Selzer, Richard

Last Updated: Aug-08-2006
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

A man dying of pancreatic cancer has reached the point where the pain is no longer controlled by morphine. In the hospital he begs for death. The surgeon tells his wife, "To give him any more would kill him." "Then do it," she says.

He returns with three syringes of morphine and finally injects them, but the man will not die. How easy it would be to suffocate him! But the surgeon rejects this thought and leaves the room, having failed to provide euthanasia.

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Search for Oz

Bronson, Richard

Last Updated: Jul-26-2006
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

This is a collection of 61 poems by physician-poet Richard Bronson. The first and largest section contains many poems related to the poet's medical life and experience, including several that arose from his formative and bittersweet years at New York's Bellevue Hospital ("A Bellevue Story," "I Shall Be Your Vasari," and "Pain"). Others re-imagine events in the history of medicine ("The Knowledge," "Plague Doctor," and "The Man Who Dissected His Wife's Brain")

The second section, "Ten Portents of the Future," contains poems that examine the symptoms and signs of contemporary malaise, but find the diagnosis uncertain and the prognosis . . . who knows? It appears grim, though: "I am a lame man / gone to seed / at the terminus of an age." ("After the Big Bang," p. 94) In his last suite of poems, "Six Aspects of Love," written to his wife, Bronson reveals his strong, but purely personal, antidote for the cruelty of our "barbarous times."

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First Operation Under Ether

Hinckley, Robert

Last Updated: Jun-30-2006
Annotated by:
Shafer, Audrey

Primary Category: Visual Arts / Painting/Drawing

Genre: Oil on canvas

Summary:

The dentist, William Thomas Green Morton, gave the first successful public demonstration of anesthesia on October 16, 1846 at the Massachusetts General Hospital. This painting depicts the patient, Gilbert Abbot, sitting in a chair in the surgical amphitheater, eyes closed and neck exposed for the excision of a small vascular tumor of the jaw.

The surgeon, John Collins Warren, a distinguished Professor of Surgery at Harvard Medical School is leaning slightly forward, delicately holding a surgical tool vertically at the hidden point of incision. Morton holds his specially designed glass apparatus used to contain the anesthetic agent, ether.

Eleven other men watch the proceedings from the floor of the amphitheater, with varying levels of surprise and concentration. One is rising, as if in amazement, from a chair, and another steps up on a chair to see better. Two attend the patient: one holds his head and the other holds the right hand and checks the pulse at the wrist. Numerous men are seated in the gallery, and are painted with less and less detail, the higher the row.

The men are all dressed formally in dark suits, some with fur lapels, except for the patient, who is in white shirt with tan pants and dark shoes. This operation occurred before antisepsis and germ theory were discovered.

Hinckley used light and line to focus attention on the surgery. A strong diagonal line from the side wall of the gallery ends at Warren’s head. Light reflects off Morton’s ether inhaler, such that one can even see the sponge inside. The white of the patient’s shirt and the cloth and bowl on the instrument table in the foreground also serve to direct attention to the operation. Light glints off the surgeon’s head, although not as dramatically as in Thomas Eakins’s The Gross Clinic (see this database). Warren’s pronouncement at the end of the surgery, "Gentlemen, this is no humbug," paved the way for the rapid acceptance of anesthesia for surgery.

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The Blood of Strangers

Huyler, Frank

Last Updated: Jun-21-2006
Annotated by:
Davis, Cortney

Primary Category: Literature / Fiction

Genre: Collection (Short Stories)

Summary:

In 28 autobiographical stories, the narrator writes of his patient encounters (and self encounters) as a medical student, resident, and finally Emergency Room attending physician. "The Unknown Assailant" opens the collection, a tale of a criminal and his victim who are both brought into the doctor-narrator's emergency room. The young doctor chooses "the young one" (p. 1), not knowing he is the assailant, and works frantically to save his life. This criminal allegedly killed two men a year before, but his current victim lives and the doctor learns the story of the attack from this victim's point of view. The assailant, who slowly recovers, has "an aura about him" (p. 5) and the doctor is strangely drawn to him, thankful that this man means him no harm. Perhaps aware of the irony of healing a man who, in another environment, might kill him, the doctor helps the assailant get better.

This underlying theme--that nothing is black and white in medicine or life--shapes every story. "Prelude," is the revealing, three-page tale of a medical student's life outside the hospital juxtaposed with his first encounter with death in the anatomy lab.

Every story deals with significant issues: the physician's inner emptiness when a patient dies ("Through the Dark, Softly"), how a greater power might suddenly intervene ("Faith"), how narrow the margin is between a successful and a missed diagnosis ("Sugar"), how both patients and residents survive because of, or in spite of, their medical attendings ("A Difference of Opinion"), and how things that seem final or sinister--like death and leeches--become instruments of hope and cure ("The Dead Lake"). [Sugar and The Dead Lake have been annotated in this database.)

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A Country Doctor

Jewett, Sarah Orne

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

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Nan Prince is an orphan who becomes the ward of the local general practitioner, Dr. Leslie, upon the death of her elderly aunt. Nan and Dr. Leslie develop a close emotional bond. She is a bright young woman who enjoys accompanying him during his long day's work as a country doctor in Oldfields. They often discuss medicine and healing. Dr. Leslie encourages Nan to read medical books, while instilling in her an understanding of the intimacies of his patients' lives and a love of caring for them. He would like to see her become a physician, an ambition she soon begins to pursue despite many obstacles. She goes away to medical school in the city.

After her first year at medical school, she spends part of the summer in the town of Dunport where she is introduced to her closest relative, Miss Prince (her father's sister), and the "smart" society she has never experienced in the country. Miss Prince and Nan's new friends are all amazed and scandalized by the thought of a woman becoming a physician. They think the whole idea is utterly outrageous, especially for a young, attractive woman like Nan.

She meets and falls in love with a young lawyer, George Gerry, who asks her to marry him. With great emotional pain (but no hesitation), Nan chooses medicine over marriage. She returns to medical school and, after graduation, to spend a year in Oldfields practicing with Dr. Leslie. In the end she stands by the river on a beautiful summer day, raises her hands to the sky, and exclaims, "O God . . . I thank thee for my future!"

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Annotated by:
Nixon, Lois LaCivita

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Set in the 1950s Eisenhower era, this film creates an enlarged snapshot of a model suburban household in Connecticut as well as a companion negative of two suppressed social issues lurking beneath the painfully smooth surface. In his effort to portray dominant values, as well as the melodramatic look and feel of the period, Director Hayes appropriates visual effects and music associated with fifties films by Douglas Sirk such as "All That Heaven Allows" with Rock Hudson and Jane Wyman. Colors are too vivid; music heavily underlines emotional elements; and stylistically designed sets reflect superficial ideals. Too perfect.

Moving from the margins and into the center two disruptive shadows gradually emerge, one dealing with race, the other with homosexuality. In the years preceding racial protests and riots and in a time when few could imagine public conversation about sexual orientations, use of condoms, or AIDS, the story reveals unspeakable abuses, intolerances, and injustices that have subsequently been addressed but not resolved.

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Epiphany

Sams, Ferrol

Last Updated: May-08-2006
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Collection (Novellas)

Summary:

Three novellas by a master storyteller. For the title story, see the separate entry in this database (Epiphany). "Harmony Ain't Easy" is a tale in which Dr. and Mrs. Sams (he retains his own name here) get stranded when their car is disabled on a country road, thanks to Dr. Sams's bull-headedness. After a warmly humorous series of reverses, they are finally saved.

In the last story, "Relative and Absolute," aged Mr. McEachern is approached by three high school students who want to interview him for their oral history project. They ask him questions about living conditions and race relations in their county when he was young. During the series of interviews, as he tells them anecdote after anecdote heavy with homey wisdom, the old man and the adolescents learn to like and respect each other.

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