Showing 271 - 280 of 480 annotations tagged with the keyword "Art of Medicine"

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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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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The Last Deal

Groopman, Jerome

Last Updated: Oct-04-2005
Annotated by:
Kohn, Martin

Primary Category: Literature / Nonfiction

Genre: Case Study

Summary:

A desperate patient visits a renowned oncologist with hope for a miraculous cure of his kidney cancer. The patient, a venture capitalist, doesn't want to die--can't face his death. He is willing to take whatever risk is necessary to survive. After a grueling course of experimental treatment and an expected period of remission, the cancer returns, leaving the patient (according to the physician-author) with an awful ending to his life--a death filled with regret.

What is revealed as Groopman deliberately walks "along the milestones" of his patient's life is more than the patient's story, however. For in addition to a chronicle of the disease's effect on his patient, the physician himself, and his concerns about the proper use of his knowledge and powerful tools also are revealed.

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Whose Body is it Anyway?

Gawande, Atul

Last Updated: Oct-04-2005
Annotated by:
Kohn, Martin

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

Atul Gawande, a surgical resident at Harvard Medical School, asks in his well written essay, "when you see your patient making a grave mistake, should you simply do what the patient wants?" (p. 86) He answers this question by sharing a number of cases from his training that suggest that the orthodoxy of 'absolute respect for patient autonomy' may interfere with good patient care.

Gawande also gives the reader insight into the difficulties that young residents especially have in developing an artful approach to medical practice. He suggests that part of respecting autonomy is (at appropriate times) allowing patients to cede that autonomy to an authority figure. He argues further that, "patients frequently don't want the freedom that we've given them." (p. 89)

He also shares in his essay a personal experience with his youngest child. She was a premature baby who at eleven days old ended up in the intensive care unit. He was glad to put the ultimate decision(s) of how to care for his daughter in the hands of physicians--"they could live with the consequences, good or bad." (p. 90)

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The Bell Curve

Gawande, Atul

Last Updated: Oct-04-2005
Annotated by:
Sirridge, Marjorie

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

Subtitled "What happens when patients find out how good their doctors really are," this article starts with an important statement: "Every illness is a story, and Annie Page's began with the kinds of small unexceptional details that mean nothing until seen in hindsight."

This is the introduction to a look at a child with cystic fibrosis and how her family sought the best care for her.

The author, Dr. Atul Gawande, goes on not only to tell their story but also the story of the way in which the understanding of this disorder has increased and the unusual rigor with which centers that specialize in the disease are evaluated.

He also includes stories of other sufferers to emphasize the importance of surveillance of their care.

These stories allow him to generalize about the way physicians' care is evaluated in general by the public and our medical organizations and how difficult it is to be at the high end of the Bell Curve. The author concludes, "When the stakes are our lives and the lives of our children, we expect averageness to be resisted."

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Saturday

McEwan, Ian

Last Updated: Sep-13-2005
Annotated by:
Belling, Catherine

Primary Category: Literature / Fiction

Genre: Novel

Summary:

This novel spans one day in the life of a London neurosurgeon, Henry Perowne. It is set on a specific day, Saturday, February 15, 2003, when mass demonstrations were held in London protesting the coming war on Iraq. This actual historical and geographical context colors the fictional narrative, told entirely from the point of view of Perowne, who wakes in the early hours of the morning to see a burning aircraft descending towards Heathrow. Although this turns out not to be a terrorist attack, as Perowne at first fears, it sets up the book's atmosphere of foreboding and the powerful contrast between dangerous world events and Perowne's essentially happy family.

The Perownes are all talented and successful and fond of each other. Henry's wife, Rosalind, is a media lawyer; their son, Theo, a blues guitarist; and their daughter, Daisy, a published poet. This Saturday's highlight is to be a family dinner, where it is expected that Daisy and her grandfather, John Grammaticus, a famous poet, will reconcile after an argument.

Henry is on the way to his morning squash game when he is involved in a minor car accident with a dubious character named Baxter. He escapes theft and a beating by realizing that Baxter suffers from Huntington's Disease. He tells Baxter the diagnosis and offers hope of a non-existent treatment, shifting the power base of the encounter from brawn to brain and humiliating Baxter in front of his cronies. (This part of the novel was published in the New Yorker as a short story, The Diagnosis. See the annotation in this database for a more detailed account.)

Henry then plays an aggressive game of squash with Jay Strauss, his American colleague, and they discuss the Middle East and the impending war. He buys seafood at the market for the evening's dinner, and he goes to the nursing home to visit his mother, Lily, who has multiple-infarct dementia. He listens to his son's band, goes home and cooks dinner. He argues with Daisy, his daughter, just come from the protest march, about the coming war.

When the family is gathered for dinner, Rosalind returns from work and Baxter and his henchmen force their way into the house. They threaten Rosalind with a knife, break Grammaticus's nose, and force Daisy to strip, at which point Perowne realizes his daughter is pregnant. Then Daisy recites poetry--Matthew Arnold's "Dover Beach"--and, unlikely as it is, the effect of the poem is to distract Baxter enough that Perowne is able to lure him upstairs with the promise of more information on treating Huntington's, and he and Theo then throw Baxter down the stairs. Baxter is taken away in an ambulance, and later Perowne is called in to operate on his brain. The novel ends with Perowne back in bed with his wife.

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Annotated by:
Willms, Janice

Primary Category: Literature / Nonfiction

Genre: Collection (Quotations)

Summary:

This slim volume dips into "quotable quotes" drawn from literature and historical writings dating back several centuries. The quotes are put forth by physicians, patients, observers of medical issues, and writers of fiction as well as essayists. Each quote is but a few lines. The author, the source, and the date (when known) are provided for each quotation.

Many of these quotations will be familiar to persons who are widely read or who study the literature by and about medicine. Some of the quotes are scatological in the sense that they address issues of bodily parts and functions; others are simply amusing, while many are profound observations. The range is wide and the selections eclectic.

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Summary:

The aim of this collage of anecdotes from medical history is largely to entertain, though it is pointedly instructive in its focus on reasons for and results of medical mistakes, misapprehensions, and serendipitous breakthroughs. Gordon's dryly humorous skepticism and general irreverence is balanced by an obvious delight in the intellectual play that characterizes the history of science.

The stories he tells range from Hippocrates to the present with a heavy focus on the 18th and 19th centuries. The book includes a good representative collection of visual art and photography documenting moments in medical history upon which Gordon casts a cold but twinkling eye. Chapter titles such as "Discoveries in the Dark," "Sex and its Snags," "Odd Practices," and "Freud, the English Governess and the Smell of Burnt Pudding" give a bit of the book's flavor.

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Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Anthology (Poems)

Summary:

This anthology of "healing poems" is designed, according to the editors, "to find readers who might not usually read poetry." They say it should also be read "by those sitting in waiting rooms in surgeries and outpatients' clinics." These are definitely large tasks to expect this small collection of poems to accomplish, but in a different world (for example, a world in which people believed in the power of poetry to heal), this particular anthology would have a good shot at becoming a standard waiting room fixture.

The therapeutic intervention is well thought out. The editors have arranged the book into eight sections, each containing poems that exemplify a different theme, or situation, or style of treatment. The sections include: Admissions, Poems to Make You Feel Better, What It Feels Like, For Those We Love, The Language of Pain, Healing Rhythms, Body Parts, and Talking to the Dead. There is considerable overlap among these categories, because good poems speak several languages and can't be pinned down to a single feature. However, the classification does serve a heuristic purpose. It is another way to hook the reader, by choosing a topic he or she likes; once inside the covers, the reader may explore at will without regard to categories.

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Annotated by:
Ratzan, Richard M.

Primary Category: Literature / Nonfiction

Genre: Biography

Summary:

Journalist Jonathan Eig traces the life of Lou Gehrig, one of the finest first basemen that major league baseball has ever known. Gehrig played as a tremendously reliable and powerful hitter for 17 seasons with the New York Yankees, the only team for which he played, many of them with Babe Ruth; he starred in 7 World Series games, playing on 6 championship teams. Gehrig's consecutive game streak of 2130 games, part of the reason for his nickname Iron Horse, was only broken recently, in 1995, by Cal Ripken, Jr. of the Baltimore Orioles.

Born June 19, 1903, Gehrig was only 35 years old when he developed the symptoms of amyotrophic lateral sclerosis, a neurodegenerative disease of vicious and progressive muscle wasting. He died June 2, 1941, quietly, at home. A relatively unknown disease at the time, amyotrophic lateral sclerosis, or ALS, soon became known as "Lou Gehrig's disease."

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