Showing 281 - 290 of 513 annotations tagged with the keyword "Art of Medicine"

First Payment

Mukand, Jon Arun

Last Updated: Aug-21-2006
Annotated by:
Nixon, Lois LaCivita

Primary Category: Literature / Poetry

Genre: Poem

Summary:

This poem by physician-poet Mukand transforms what might be unobserved and ordinary into the visible and extraordinary. A frail old woman with a disease of "no cure," probably cancer, is in the waiting room at a hospital or clinic. The narrator, whom we suspect is the second character, as well, a medical student, spins with delicacy a thoughtfully real and imaginative description of the waiting patient.

Readers see her "blue gauze scarf," "her gnarled, polished walking stick," and her pained body, but are provided with, additionally, an imaginary account of the effects of the disease on the woman as she struggles with pain through her final months. When the student enters the waiting room, the woman extends her "brittle" hand, then pulls from her black bag a sealed envelope. When instructed to open it, the student finds a fifty-dollar bill "to help with school." Caught by surprise, he smiles, but leaves the bill in her palm: "It lies in her palm like a / handful of earth picked up, raised / to the sky / as an offering to the spring wind."

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Father and Son

Gosse, Edmund

Last Updated: Aug-21-2006
Annotated by:
Holmes, Martha Stoddard

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Victorian critic and poet Edmund Gosse was the child of respected zoologist Philip Gosse, a minister within the Plymouth Brethren, a fundamentalist evangelical sect. This memoir of Gosse’s childhood and young adulthood details his upbringing by parents whose faith and literal approach to Scripture directed all their domestic practices.

It details the older Gosse’s agony as he struggles to reconcile his scientific vocation with his religious faith in the face of the hefty challenges posed by Chambers, Lyell and Darwin’s mid-century hypotheses about the age of the earth and the diversity of its species.

Edmund’s own agony as he realizes his inability to fulfill his parents’ expectations for him in terms of religious vocation is another significant thread. While "father and son" is the primary relationship explored, the early parts of the memoir describe Emily Gosse’s influence on her son, particularly during her illness and death from breast cancer.

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Doctors

Sexton, Anne

Last Updated: Aug-17-2006
Annotated by:
Aull, Felice

Primary Category: Literature / Poetry

Genre: Poem

Summary:

An even-handed consideration of the essence of doctoring, this poem packs into a few short lines the paradoxes, frustrations, rewards, and dangers inherent in the profession. It depicts the doctor’s power, skill, humanity, dedication, and sometime arrogance, and the arena in which the work is done--"they are only a human / trying to fix up a human." Sexton warns that arrogance has profound consequences: "If they [doctors] are too proud, . . . then they leave home on horseback / but God returns them on foot."

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Annotated by:
Belling, Catherine

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

The work consists of twenty-three devotions, each in three parts--a meditation, an expostulation, and a prayer--recording and exploring Donne’s experience of illness (probably typhus). The work traces the disease’s course and treatment, beginning in the first devotion with the first signs of illness, moving through the patient’s taking to bed and sending for physicians, their prescribing and carrying out various treatments, and a worsening of symptoms followed by the crisis where, in Devotion 17, the patient prepares himself for death. He then begins to recover, the physicians purge him, and, like Lazarus, he rises from his bed. The physicians then try to correct the cause of the disease in him, and, in the final devotion, warn the patient that a relapse is not out of the question.

Donne explores the spiritual implications of each stage of his illness, using the experience of his body to provoke reflections on the health of the soul. For instance, in the first devotion he asks why sin, unlike physical sickness, does not show early signs which might enable one to get treatment in time. Donne uses the arrival of the physicians to explore Christ’s role as physician to the soul, and the spots which appear on his body to meditate on Christ as the unspotted carrier of human stains.

Anticipating death, he considers the relationship of soul and body, seeing the body’s death as the cure of the disease. He then sees the physicians as God’s instruments in curing his body and miraculously raising him from illness. Finally, he argues that the root of all illness is internal, lying in the sin which infects his soul, and that therefore he must work constantly to prevent the relapse which continues to threaten.

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Annotated by:
Woodcock, John

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

The surgeon Jack McKee (William Hurt) carries on an outwardly successful practice while treating his patients with aggressive sarcasm and general disrespect. "There is a danger in becoming too involved with your patients," he warns his residents, reminding them of the surgeon’s credo: "Get in, fix it, get out." Then McKee himself is diagnosed with cancer of the vocal chords, and the doctor discovers patienthood. The process is enormously uncomfortable for him, as he experiences a sharp decline in autonomy and everything that goes with it, and he begins to develop some empathy for those he has always scorned.

Particularly inspiring are several encounters with a coldly professional specialist and a platonic friendship with a young cancer patient named June (Elizabeth Perkins) who is dying because her doctors failed to diagnose her brain tumor. By the end of the film, Dr. McKee is both recovered and converted, and in the last scene is requiring his residents to spend 72 hours as hospital patients as part of their medical training.

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The Death of Ivan Ilyich

Tolstoy, Leo

Last Updated: Aug-16-2006
Annotated by:
Nixon, Lois LaCivita

Primary Category: Literature / Fiction

Genre: Novella

Summary:

Tolstoy’s short novel is more than a classic portrayal of dying and suffering. While those issues are central in most discussions of this work, an equally important and overlapping theme concerns choices made in life. Ivan, the protagonist, followed a well-traveled road, adhering to "comme il faut" (as is expected) or doing what one was supposed to do in career matters, selection of clothes, choosing a wife, raising children.

There is little to admire about this generally successful but thoughtless and selfish man. Ivan’s inability to invest meaningfully in family, social, or professional relationships leads to frightening consequences when he becomes gravely ill, probably with pancreatic cancer. Five different physicians with attitudes that range from arrogant to dishonest offer little assistance or compassion.

His family soon loses patience with his suffering and tends to blame him for the onset of illness. Only Gerasim, a peasant hired to assist him in his most basic needs, provides the kind of care and understanding required by the dying and increasingly isolated or deserted sufferer. The first chapter is masterful in its presentation of responses to death by friends and family members and prepares readers for the consequences of shallowness in an unlived life.

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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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