Showing 271 - 280 of 424 annotations tagged with the keyword "Professionalism"

Delivering Doctor Amelia

Shapiro, Dan

Last Updated: Jan-28-2004
Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Case Study

Summary:

Subtitled "The Story of a Gifted Young Obstetrician's Mistake and the Psychologist Who Helped Her," this is an absorbing account of a young female physician's torment following the difficult delivery of a baby who was soon thereafter diagnosed with cerebral palsy. "Doctor Amelia" seeks counseling after she has taken an indefinite leave of absence from her practice and faculty position. The book intertwines reconstructed counseling sessions in the voice of the doctor-patient, with the therapeutic strategy and personal reflections of her therapist, author Dan Shapiro.

The obstetrician enters therapy because she has lost confidence in her professional abilities. Once deeply engaged in her chosen profession, she has lost her enthusiasm for it and feels "numb." Her marriage is under strain. When asked if she is suicidal, she hesitates and then denies she is. Shapiro thinks there may be trouble ahead, and so does the reader. Gradually, Doctor Amelia reveals the incident that triggered her changed emotional state. She had delayed performing a cesarean section on a patient who was in extended labor and whose baby was showing deceleration of its heartbeat rate. A few weeks later, the baby's pediatrician informed Doctor Amelia that the baby had cerebral palsy and now the baby's parents are filing a lawsuit.

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Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Poetry and Art

Summary:

This book represents collaboration between neurologist-poet Jerome Freeman and potter Richard Bresnahan. Thirty-seven black-and-white photographs of ceramic pieces by Bresnahan from the Minneapolis Institute of Arts are interspersed with 56 of Freeman’s short poems. In his introduction Freeman writes, "Richard’s pottery (champions) both our environment and the need to nourish our humanity through cooperation and caring." Likewise, Freeman notes that much of his own poetry "attempts to focus upon caring." As he also points out, "the economy and simplicity of pottery can resemble the spare verbiage and subtlety of successful poetry."

Indeed, Freeman’s poems are simple, direct, and evocative. Many of them, such as "Carrying On" (p. 3), "Ten Year Old with Rheumatoid Arthritis" (p. 17), and "DTs" (p. 49), create images of patients. (However, the 88-year-old arthritis sufferer in "Carrying On" by no means considers himself a patient!) Others evoke more general human responses to severe illness ("Apocalypse," pp. 6-7), or to the threat of illness ("In Defense of the Hypochondriac," p. 15). In the former, Freeman writes of a comatose ICU patient, "All about keep mostly / thinking there’s a mistake / here somewhere." In the latter poem, Freeman concludes, "The worst might / happen. Keep crossing / bridges before you come / to them."

These poems also evoke the landscape and flora and fauna of the Great Plains: "Lake Superior in February" (p. 29), "The Prairie Gentian" (p. 79), and "When Wild Turkeys Come Out of the Woods" (p. 87). But the outside and inside worlds are closely connected. In "Coma Vigil" (p. 59), a poem about a woman in a persistent vegetative state, he begins, "Dawn’s bounty spills over / the rim of sky to spread / across darkened / prairie." Does the woman want to be kept alive in her "coma vigil"? The poem ends, "The time has / come. / Shadows still conceal / easy ways of letting / go."

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Annotated by:
Kennedy, Meegan

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

St. Luke’s Hospital was founded in 1750 to provide free care to the impoverished mentally ill. It mixed benevolence with "unconscious cruelty" in the treatments used by the "practitioners of old," from restraints and drugs to swings and a key to force-feed recalcitrant patients. Dickens describes this gloomy edifice as he saw it on December 26, 1851, although he notes a "seasonable garniture" of holly.

The inhabitants of St. Luke’s largely sit in solitude. Dickens decries the absence of "domestic articles to occupy . . . the mind" in one gallery holding several silent, melancholy women, and praises the comfortable furnishings--and the relative "earnestness and diligence" of the inmates--in another. He uses statistics to show the prevalence of female patients, "the general efficacy of the treatment" at St. Luke’s, and the unhealthy weight gain of the inhabitants due to inactivity. Dickens describes the behavior of various distinctive inhabitants during the usual fortnightly dance, the viewing of a Christmas tree, and the distribution of presents.

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Summary:

Benigno (Javier Cámara) and Marco (Darío Grandinetti) meet and become friends while caring for women they love in a coma clinic. Benigno is a male nurse taking care of Alicia (Leonor Watling), a dancer he barely knows but became infatuated with just before the accident that put her in a coma four years ago. Marco is a journalist who was trying to interview Lydia (Rosario Flores), a famous female bullfighter, when they fell for each other. Soon afterward, she is badly gored in the bullring and winds up in a coma in the same clinic as Alicia.

Benigno’s care of Alicia in her comatose state is extremely devoted. He talks to her constantly, and he goes to movies he thinks she would have liked and tells her about them. Alicia’s dance mentor (Geraldine Chaplin) also talks to her, and Benigno urges Marco to do the same with Lydia, but Marco is unable to talk to Lydia, whom he thinks of as already dead (there is reason to think that she is, in fact, more gravely injured than Alicia).

Benigno’s caring goes well beyond talking. He tells Marco that he wants to marry Alicia. He also gives Alicia intimate massages, and finally the hospital staff discover that he has impregnated her. He is fired and sent to jail, where he takes his own life. In the end, while Lydia dies, Alicia comes out of her coma to deliver the child, which is stillborn. Marco’s last words to Benigno, at Benigno’s grave: "Alicia is alive. You woke her up."

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Alias Grace

Atwood, Margaret

Last Updated: Nov-17-2003
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

For more than fifteen years, Irish-born Grace Marks has been confined for the 1843 murder of housekeeper, Nancy Montgomery, and her employer, Thomas Kinnear, at their home north of Toronto. Her convicted accomplice was hanged, accusing Grace with his last breath, but her sentence was commuted to life in prison at the last minute. Because of her amnesia and outbursts of rage and panic, she was held in the Lunatic Asylum before being sent to the Kingston [Ontario] Penitentiary.

Beautiful, intelligent, and strangely poised, Grace intrigues worthy townsfolk, spiritualists, and some of her jailers, who grant her the privilege of outside work, believe in her innocence, and strive for a pardon. In looking for medical approbation, they consult Dr. Simon Jordan, a young American doctor who is interested in insanity and memory loss. Without explaining his purpose, he brings her vegetables and other familiar objects, hoping to stimulate recollection of her life.

Interspersed with Jordan's own problems, Grace's story unfolds in her own words, from her poverty-stricken childhood in Ireland and the emigration voyage that killed her mother, leaving her and her younger siblings to a neglectful father, through her short life in service, to the dreadful events of autumn 1843. She has suffered many losses, including the death of her mother to ship fever, and that of her friend and fellow servant, Mary Whitney, from an illegally procured abortion. After many weeks, Jordan abandons his project in frustration and ambiguity. The novel ends years later with forty-six year-old Grace's discharge from prison in 1872, nearly thirty years after the crime.

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James Miranda Barry

Duncker, Patricia

Last Updated: Nov-16-2003
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

A child of a beautiful, talented woman and ambiguous paternity craves learning. Adopted by a Spanish officer and an "uncle" who is a painter, s/he is sent off to Edinburgh as a pedagogic experiment to become James Barry, a male medical student. Barry adores the vivacious Alice, an illiterate but intelligent servant, whom he teaches to read.

Later as a doctor and medical officer, he travels the world to the Crimea, to the Caribbean, to South Africa and America, a scion of society and a good scientist. By happy fortune, he lives in retirement with Alice, who has become a famous actress. The book ends with the scandalous revelation of Barry's femininity when his body is laid to rest.

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Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

This book, "a humanistically oriented sociocultural history of medicine" (p. x), focuses on the interactions between patient and doctor in western medicine from the nineteenth century through contemporary times. Furst, a Professor of Comparative Literature at the University of North Carolina at Chapel Hill, uses literary works to chronicle the changing patterns of medical practice, the social positions of doctors, and effects of medical education as they relate to "the doctor-patient alliance." (p. x) By "mapping cultural history in and through literature" (p. x), Furst enriches our understanding of the development of various roles and expectations of doctors and patients since approximately 1830.

The first chapter details the concept of the book and clarifies its purpose. Most histories of medicine concern famous discoveries, introductions of new technologies, and lives of renowned physicians and researchers, yet they neglect to examine patients' perspectives. Furst's mission is to reinstate patients into medical history and contemporary analysis. She chooses to focus on everyday-type of medicine, and more specifically, "to chart the evolution of the changing balance of power in the wake of the advances made in medicine in the nineteenth and twentieth centuries, drawing on literary texts as sources." (p. 17)

The other seven chapters are topic oriented and placed in general chronological order. The chapters vary in the number of sources examined. For example, Chapter 2, "Missionary to the Bedside" is a comparative analysis of Anthony Trollope's Doctor Thorne (see this database) and Elizabeth Gaskell's Wives and Daughters, and Chapter 3, "Seeing-and Hearing-is Believing" almost exclusively concerns Middlemarch by George Eliot (see this database).

Other chapters, however, include commentary on more sources. A chapter on twentieth century hospital-based practice and medical education, "Eyeing the Institution," begins with a review of various films, television shows, and novels and follows with an in-depth comparative analysis of three autobiographical accounts of medical education and training: A Year-Long Night by Robert Klitzman, A Not Entirely Benign Procedure: Four Years as a Medical Student by Perri Klass (see this database), and Becoming a Doctor by Melvin Konner.

Furst examines the effect of gender on patient and physician experiences and expectations. In Chapter 4, "A Woman's Hand," five novels about "doctresses" (a term used for women doctors in the late nineteenth century) are compared. How and why the protagonists became doctors, what sacrifices they made, how patients viewed having a woman doctor, the range of solutions to career and/or marriage choices, and the personalities of the protagonists are some of the comparisons made. These novels are placed in historical context with information about the lives and attitudes of physicians such as Elizabeth Blackwell and Mary Putnam Jacobi.

Other topics include evaluations of the nineteenth century hospital, the role of research and the laboratory (Sinclair Lewis's Arrowsmith annotated by Felice Aull, also annotated by Pamela Moore and Jack Coulehan --see this database--and A. J. Cronin's The Citadel), and the impact of contemporary changes in reimbursement and management on the power relations in medicine. A sensitivity to the effects of language on power relations is a theme throughout the book, and is more fully examined in the final chapter, "Balancing the Power." After an analysis of several books by Oliver Sacks , and his attempts to truly understand his patients' perspectives, Furst concludes, "The balance of power cannot be even, but it must at least strive to be fair." (p. 251)

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Annotated by:
Woodcock, John

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

In 1930s London, a doctor is visited by his wealthy and powerful patient Beatrice Glendenning, who demands an abortion. Although the doctor is an occasional guest of this woman and her husband at their country estate, the law requires that he refuse her request, and he advises her to have the child--and most certainly not to get a backstairs abortion. She tells him that it is not her husband's child, that bearing it would never do, and storms out of the office.

Ten days later her husband calls the doctor to ask if he could drop by the Glendenning townhouse and look in on Beatrice, who, he says, has the flu. The doctor goes, and discovers that she has gotten an infection from an undercover abortion. He feels trapped, but he treats Beatrice anyway, resenting her the whole time. The husband maintains his story that Beatrice has the flu, and the doctor leaves thinking that the husband never suspected. In the fall, as usual, he is invited to a pheasant shoot on the Glendenning estate.

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The Imaginary Invalid

Molière

Last Updated: Oct-21-2003
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Plays

Genre: Play

Summary:

Argan, a fearful but miserly hypochondriac, divides his time between summoning the doctor to care for his ills and trying not to settle the resultant bills. He resolves to marry his daughter, Angélique, to a medical student, hoping to acquire unlimited access to gratis consultation. The chosen fiancé is an unattractive dolt, who would never interest Angélique, even if she were not already in love with clever, handsome Cléante, who poses as her music instructor.

Argan's wife, however, plans to send Angélique to a convent, removing her from the line inheritance. At the urging of the sensible servant Toinette, he feigns death to test his wife's affection only to discover her contempt. Again with the help of Toinette, the young lovers convince Argan to liberate himself from the twin tyrannies of his ailing body and his grasping physicians by becoming his own doctor. The play closes with the physicians' lively examination of Argan and his entry into the profession, full of musical pomp and pidgin Latin.

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Before the Change

Munro, Alice

Last Updated: Oct-21-2003
Annotated by:
Belling, Catherine

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The story, set in small-town Ontario in 1960, takes the form of letters to her ex-fiancé from a young woman who has returned to the home of her father, a widowed physician who lives with his housekeeper, Mrs. Barrie. She recalls growing up with her strict and remote father and realizes now that he had been performing illegal abortions all her life. He will not discuss it, will not allow the word "abortion" to be said in his house, though she tells him she believes abortion should be legalized.

We are led to suspect that she herself has recently been pregnant.

When Mrs. Barrie breaks her arm, the doctor is forced to ask his daughter to assist with one of his "special" patients. She helps the young woman throughout the procedure, and disposes of the aborted fetus afterwards. Later, trapped indoors by a heavy snowfall, she and her father are sitting together at the kitchen table when she tells him about her own pregnancy.

She had carried it to term, giving up the baby for adoption. She had ended the engagement because her fiancé, a theology student, had insisted that she have an abortion before their wedding because he feared the social consequences of rumors that she had been pregnant before marriage. She is about to ask her father about his own work, and about what might happen should the law change and abortion become legal, when she realizes that he is not listening. He has had a massive stroke, and dies later the same day. The daughter turns away the next patient who calls about having an abortion.

She learns from the lawyer that, mysteriously, her father had virtually no money saved. She gives Mrs. Barrie most of the small amount her father had given her, and then realizes that all his money has already been given to Mrs. Barrie, either because she was blackmailing him, or because he loved her. She cannot tell which, but is oddly exhilarated and is now able to say goodbye to her fiancé for good.

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