Showing 261 - 270 of 426 annotations tagged with the keyword "Professionalism"

The City

Updike, John

Last Updated: May-11-2004
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

While on an airplane, Carson experiences abdominal pain. He is a divorced man in his fifties and a sales representative for a computer and information technology firm. He spends much of his time traveling and fancies himself "a connoisseur of cities." The increasingly severe stomach pain forces Carson to reschedule his business meeting and retreat to his hotel room.

His suffering mounts and he decides to visit the emergency department of the city hospital. Carson is evaluated by two young male doctors and later a middle-aged female physician. Despite blood tests and X-rays, his diagnosis remains murky and a surgical consultation is obtained. The surgeon suspects appendicitis. He postulates that Carson may have a retrocecal appendix and explains that in such cases the anatomical location of the organ often confounds the diagnosis.

Carson undergoes surgery. His appendix is indeed retrocecal and rupturing. He spends five days convalescing from the operation. During that time he acquires an intimate knowledge of the city from his stay at the hospital. The experience revitalizes him. Carson reasons that the world is miraculous in part because it is so simple yet still spectacular.

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Emergency

Johnson, Denis

Last Updated: May-11-2004
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

For three weeks the narrator has been working as a clerk in the emergency department. His good friend, Georgie, is a hospital orderly. Both men abuse drugs, and Georgie steals them from the hospital. The ER staff includes Nurse (an overweight woman who shakes) and the Family Service doctor (a physician with limited competence who is not well-liked).

At 3:30 A.M., a man named Terrence Weber arrives at the ER. He has a hunting knife stuck deep in his eye. Ironically, his other eye is artificial. Weber's wife apparently tried to blind him because he ogled the woman next door. The doctor immediately decides the situation is beyond his expertise and calls for an ophthalmologist, neurosurgeon, and anesthesiologist.

Meanwhile Georgie is prepping Weber for surgery. The drugged-up orderly, who cannot even tie his shoe at this point, somehow removes the knife by himself. Weber's vision is fine. Later on, the narrator and Georgie get lost while driving around in a pick-up truck without headlights. The truck runs over a jackrabbit on the road. Intent on making rabbit stew, Georgie cuts the animal open with the hunting knife he had earlier removed from Weber's eye. The rabbit is pregnant with eight miniature bunnies inside her.

Georgie decides to save the babies. Unfortunately the narrator forgets about the rabbits and accidentally squashes them to death. At the end of the story the two men encounter a hitchhiker who has gone AWOL from military service. Georgie promises to take him to Canada.

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The Dream of Scipio

Pears, Iain

Last Updated: May-10-2004
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Manlius is a 5th C Roman patrician living in Provence who has studied with the wise, reclusive Sophia. He writes his understanding of her teaching in his essay, 'Dream of Scipio,' which trades on an essay by the great Roman orator, Cicero. Sensing that the Empire is gravely threatened, he makes a pact with barbarians, sells out his neighbors, slays his adopted son, and becomes a bishop of the Christian religion, which he has long despised. Late in this ruthless and doomed attempt to salvage what he values most in his world, Sophia makes it clear that he has misunderstood her teaching.

Olivier is an astonishingly gifted 14th century Provencal poet whose intolerant father tries to stifle his love of letters, among which is Manlius's 'Dream'; his father destroys the manuscript, but Olivier recopies it from memory. As plague advances on their region, Olivier finds a mentor in the high churchman, Ceccani, who is bent on keeping the papacy in Avignon. He plans to destroy Jews as symbolic expiation for plague, widely construed to be a form of divine punishment. Olivier befriends a Jewish scholar and falls in love with his beautiful heretic servant.

The 'Dream' and the imprisonment of his friends lead Olivier to question and then betray his mentor. Either because of his efforts to save them, or for his role in a murder, he is mutilated--his tongue and hands cut off to rob him of speech and writing. The brutal mutilation appears early in the book--it is not fully explained until the end.

Julien is a French historian who has studied the poet, Olivier, and the rendition of Manlius' manuscript. He finds solace in his erudition as his county falls to the Nazi occupation. An old school friend who is a collaborator, gives him work as a censor and tolerates Julien's Jewish lover, the artist Julia. In the end, Julien is forced to choose between saving either another school friend in the Resistance or Julia. He chooses Julia, looses her anyway, and commits suicide in a vain attempt to warn his friend.

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The Doctor

Chekhov, Anton

Last Updated: Apr-21-2004
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The physician Tsvyetkov visits a child who is dying of a brain tumor, and the boy's mother. There is no hope, nothing to be done. Tsvyetkov has had one romantic fling in his life; when he was younger, he had an affair with the boy's mother. She has always told him that Misha was his son. Yet she also had affairs with other men around the same time; one of them might be the father. Tsvyetkov suspects that she insists that he is the father just so he will continue to make payments to support them, which he has always done. As he leaves, he asks the boy's mother one last time, "It can make no difference now. Is the boy mine?" She hesitates for a moment, but answers, "Yes. he is your son."

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Letters to a Young Doctor

Selzer, Richard

Last Updated: Apr-12-2004
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Collection (Short Stories)

Summary:

This is a collection of 23 stories, five of which take the form of "letters" in which an older physician (not surprisingly, a surgeon) gives advice to an imaginary young surgeon. However, every one of the stories "fits" as a tale that might be told in such a letter--assuming the author was a wise and gifted writer, in addition to being a surgeon.

The book begins with the gift of a physical diagnosis textbook on the occasion of the young doctor's graduation ("Textbook") and ends with a reflection on "your first autopsy" ("Remains"). Among the other stories are Imelda (see annotation), Brute (see annotation), Toenails (see annotation), Mercy (see annotation), "A Pint of Blood," "Witness," "The Virgin and the Petri Dish," and "Impostor."

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Regarding the Pain of Others

Sontag, Susan

Last Updated: Mar-08-2004
Annotated by:
Davis, Cortney

Primary Category: Literature / Nonfiction

Genre: Criticism

Summary:

When we view photographs of war-torn bodies, piled-up corpses, or starving children, are we changed? How about the photographer, whether a professional or an amateur, who takes such pictures? Do these photographs teach us about suffering--or do they numb us over time and simply cause us to turn away? In this slim book Sontag re-visits her ideas in "On Photography," published 25 years ago.

Her aim, it seems, is not so much to answer the above questions but to provoke us by her statements, urging us at least to THINK about what happens when suffering is viewed third hand; because after all, she reminds us, we see only what the photographer wanted us to see. When scenes of violence are as close as our morning papers or our TV screens, Sontag's is an important debate.

She also gives a brief history of photo-journalism, from the Crimean and Civil Wars to the almost instantaneous transmission of images from Operation Iraqi Freedom. In chapters that sometimes seem to disagree with one another, she plays the devil's advocate and views the IDEA of photographs of suffering from all directions. Can gruesome photos be artistic? Should they be? And if a war photo is posed--a corpse moved for a better shot or a battle scene restaged to make it more dramatic--is the effect enhanced or decreased? She considers the impact of candid photos versus those technologically manipulated; she discusses how photos, and their impact on us, change when the names of the victims are revealed.

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Summary:

The new interns, Roy Basch (Tim Matheson), Chuck (Howard Rollins, Jr.) and Wayne Potts (Michael Sacks), begin their year of internal medicine training in a busy city hospital under construction. After initial introductions led by the vague staff man and vapid chief resident, they become the specific charges of the cynical resident doctor "Fats" (Charles Haid). Fats teaches them attitude and language: how to "buff" (improve) and "turf" (transfer) "gomers" (Get Out of My Emergency Room)--the words used to describe management of incurable, hateful patients who "never die," regardless of the abuse the clumsy housestaff might inflict. But Fats has heart.

Soon, they fall under the command of the militaristic and lonely woman resident, Jo Miller (Lisa Pelikan), who cannot bring herself to withhold treatment, even at a patient's request. She blames underlings for the failings of medicine and nature, as well as herself.

Wayne throws himself from the hospital roof because of a misplaced sense of guilt over a patient's demise. Roy falls in love with the nurse, Molly (Kathryn Dowling), but nearly loses her as he begins to emulate Jo's cold, calculating style. He is "rescued" in the nick of time by his friends, Fats, and the death of a physician patient (Ossie Davis) whom he admires. With recovered equanimity and renewed anger over the suicide of his fellow intern, Roy refuses to go on with his residency.

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Annotated by:
Sirridge, Marjorie

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

The author comments initially that most physicians become involved in the stories of their patients' lives--as witnesses, chroniclers, and players. He uses as an example the story of a physician's role in the death of Anton P. Chekhov. Another interesting example is the book, A Fortunate Man (see this database), the story of an English country doctor who matures in the profession and comes to recognize the task of the doctor as one to help his patients feel recognized.

Dr. Verghese believes that all patients seen by physicians are in the midst of a story that begins the moment they walk through the portals of a hospital or a clinic. He sees the challenge as engaging the patient and the family in finding an "epiphany," even if that epiphany is simply the understanding that there is nothing more that can be done medically. In his conclusion he says that as physicians we should be ministers of healing, storytellers, storymakers, and players in the stories of our patients and ourselves.

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Annotated by:
Sirridge, Marjorie

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

The author, Samuel Shem, opens these reflections by saying that he was a writer before he was a doctor. His early answers to questions about healing came from stories he read. "Life as it should be in addition to life as it is" became the "motor" of his writing. He loved stories that he heard from patients and the "few humane doctors" he met and decided he would be able to understand people better by writing about experiences with them.

Shem's experience as an intern spawned The House of God (see this database) and he sees writing about his training as an example of the use of resistance when he saw "something unjust, cruel, militaristic or simply not right." He recommends the following to resist the inhumanities in medicine: (1) Learn our trade in the world, (2) Beware of isolation, (3) Speak up, (4) Resist self-centeredness. He says that the healing essence of narrative is in "we," meaning the patient and the physician.

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Annotated by:
Coulehan, Jack

Primary Category: Literature / Literature

Genre: Anthology (Mixed Genres)

Summary:

This is a new collection of poetry and short prose by nurses, edited by Cortney Davis and Judy Schaefer, whose remarkable first anthology, Between the Heartbeats: Poetry and Prose by Nurses [see annotation in this database], may be the founding document of "nurse writing" as a recognizable genre. In the Foreword, Cortney Davis comments on the process of selection and sketches the similarities and differences between this and the previous volume.

One of the interesting similarities is that nurses write more often about birth than death; one of the differences is the wider range of topics, including nurses who reveal their own experiences as patients (see Amy Haddad, "Conversations with Wendy," pp. 100-102) and others whose fatigue and frustration cause them to step away from nursing (see Pamela Mitchell, "A Nurse's Farewell," pp., 149-151)

As in Between the Heartbeats, the authors of Intensive Care appear in alphabetical order, which favors variety and surprise over categorization. In "Medical Ward," the first poem (pp. 1-2), Krys Ahlman captures many of the themes of the anthology. "I was wearing a thousand tiny failures," Ahlman writes, and concludes: "I held out my hand, I said / I am not afraid to cry."

Intensive Care is full of delights. As advertised, there is much about bringing children into the world and caring for them; for example, Lynn Bernardini's reminiscence, "Does This Day Mean Anything to You?" about having given up her own baby for adoption (pp. 11-16); Celia Brown's poem "Forget-Me-Nots" (pp. 35-36); and the powerful but ambiguous hope of "Neonatal ICU" (Leigh Wilkerson, p.247). There are the painful memories of dying children and adolescents, especially Jeanne Bryner's amazing, "Breathless" (p. 42) and "Car Spotting, " (pp. 173-184), a story by Christine Rahn about a terminally ill adolescent. In "Car Spotting" the head nurse criticizes the young narrator because, "You become too personally involved with the patients . . . Nurses must make decisions based on objective data. Becoming too attached can cloud professional judgment." (p. 175) I found this an interesting statement coming from a nursing instructor--it could well have been made by a professor of medicine to a third year medical student.

Other major themes include the humor of nursing (see "RX for Nurses: Brag!" by Kathleen Walsh Spencer, p. 203; and "What Nurses Do on Their Day Off," Judy Schaefer, p. 188); women's health (see "Every Day, the Pregnant Teenagers," Cortney Davis, p 69; and "Redemption at the Women's Center," Jeanne Lavasseur, pp. 132-133); nursing the elderly (see "Home Visits," Paula Sergi, pp. 195-196); and the wonderful narratives of patient care (see "Sarah's Pumpkin Bread," Terry Evans, pp. 87-90; "Edna's Star," Chris Grant," pp. 95-99; and "That Mystique," Madeline Mysko, pp. 158-167). Finally, Intensive Care looks back thoughtfully in a number of pieces to nursing in military settings.

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