Showing 271 - 280 of 430 annotations tagged with the keyword "Professionalism"
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.
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.
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.
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.
Winter investigates the process by which Freudian psychoanalysis became legitimized within modern Western culture and internalized as a kind of "psychological common sense" (4). She argues that Freud's adoption of the Oedipus myth allowed him to draw on the cultural status of classical scholarship and claim the universality of the tragic theme for his own project. She traces how Freud worked to establish an institutional infrastructure for psychoanalysis, to establish it as a profession. His analysis of culture and society represents another strategy in establishing and extending the importance of psychoanalysis: the claim that psychoanalysis powerfully illuminates not only the workings of the human brain (the domain of psychiatry, psychology, and neurology) but also the functions of society (the analytic domain of anthropology and sociology).
Auden wrote this poem in memory of his own physician, Dr. David Protetch. He begins, "Most people believe / dying is something they do, / not their physician . . . " Auden, whose father was a physician, knows better. His father had warned him about doctors who are too aggressive or too concerned with money. Fortunately, he found a consultant who thought as his father did, perhaps because he (Dr. Protetch) had himself "been a victim / of medical engineers / and their arrogance, / when they atom-bombed / your sick pituitary / and over-killed it."
While prescribing for Auden’s minor complaints, Protetch himself was "mortally sick." Because of this, Auden felt that he could trust his doctor to tell him the truth about his medical condition: "if I were dying, / to say so, not insult me / with soothing fictions." Thus, Auden praises Protetch for having been, "what all / doctors should be, but few are . . . " [78 lines]
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.
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."
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.
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."