Showing 31 - 40 of 799 annotations tagged with the keyword "Communication"
Summary:Many are familiar with these stories from the author's practice as a midwife among the urban poor in London's East End in the 1950s. Each piece stands alone as a story about a particular case. Many of them are rich with the drama of emergency interventions, birth in complicated families (most of them poor), home births in squalid conditions, and the efforts of midwives to improve public health services, sanitation, and pre- and post-natal care with limited resources in a city decimated by wartime bombings. As a gallery of the different types of women in the Anglican religious order that housed the midwives and administered their services, and the different types of women who lived, survived, and even thrived in the most depressing part of London, the book provides a fascinating angle on social and medical history and women's studies.
Summary:The physician-narrator is looking in on a 30 year old patient named Ricky. Readers immediately learn that the patient has cerebral palsy: his ear mashed flat, his neck contorted into a tight C, almost quadriplegic. These first stanza clinical observations are indisputable. The narrator then shifts from the medical facts to more subjective thoughts ranging from Ricky’s previous treatment responses and medications to Ricky’s adult heterosexual response to the proximity of a female, and finally to the narrator’s own wishes for this patient. Ricky’s parents, the narrator notes, have similarly but uncomfortably witnessed their son’s ogling response to a pretty nurse or doctor or a provocative adult television image. The parents’ response, he notes, to these observations has been to redirect Ricky’s focus by switching the channel to Nickelodeon, a program geared towards children. Not unlike situations in several writings by William Carlos Williams, this physician has moved from objective medical information to his own interior thoughts about Ricky’s circumstances and confinement. Rather than sticking with the facts associated with the patient’s medical condition, he wonders, imagines, and expresses in this poem seemingly un-doctorly thoughts.
Summary:After eleven minutes underwater at near-freezing temperature, Delaney Maxwell, who appeared dead upon rescue, is revived. Unlikely as her survival seems, the return of apparently normal brain function seems even more unlikely, yet after a few days she is allowed to go home with medications and resume a near-normal life. But after-effects of her trauma linger, the most dramatic of which is that she develops a sixth sense about impending death. She hides this recurrent sensation from her parents, and from her best friend, Decker, who rescued her, but finds that she shares the experience with a hospital aide who, like her, suffered a coma after a car accident that killed his family members. Like her, he senses death in others. Gradually Delaney realizes that “normal” isn’t a place she’s likely to return to, and that Troy, the aide whose life has been a kind of “hell” since his own trauma, is even further from normal than she. Troy seems to feel that it is his mission to help hasten death for those who are dying, to prevent prolonged suffering. The story follows her efforts to stop him, and to communicate with close friends, especially Decker, in spite of the secret she carries about her own altered awareness. When her efforts to save a friend who is dying of a seizure fail, Delaney faces another moment of crisis, compounded by Troy’s own suicidal desire to end his own suffering and hers with it. In the midst of these new traumas a clarity she has lost about what it means to choose life returns to her, and with it the possibility of a loving openness with parents and friends about the mysteries of her own brain and heart.
Summary:Beginning in 1992, Mark Duxbury and Dean McClellan are high-flying salesmen for Johnson and Johnson, Ortho branch – happily promoting the drug Procrit, (or Epogen -- erythropoietin), for anemia. The drug stimulates the bone marrow to produce more red blood cells. Developed by fledging company Amgen, it was licensed to Ortho for specific uses. Their careers take off, and they earn bonuses and stature, peaking in 1993. Soon, however, Duxbury realizes that he is being encouraged to promote the drug for off-label uses and in higher doses that will enhance sales and profits through kickbacks. He soon realizes that the drug is not safe when used in these situations. People are dying because their unnaturally thickened blood results in strokes and heart attacks.
Summary:When nine-year-old Rob Cole, child of poor 11th-century English farmers, loses his mother, he is consigned to the care of a barber-surgeon who takes him around the countryside, teaching him to juggle, sell potions of questionable value, and assist him in basic medical care that ranges from good practical first-aid to useless ritual. When, eight years later, his mentor dies, Rob takes the wagon, horse, and trappings and embarks on a life-changing journey across Europe to learn real medicine from Avicenna in Persia. Through a Jewish physician practicing in England, he has learned that Avicenna’s school is the only place to learn real medicine and develop the gift he has come to recognize in himself. In addition to skill, he discovers in encounters with patients that he has sharp and accurate intuitions about their conditions, but little learning to enable him to heal them. The journey with a caravan of Jewish merchants involves many trials, including arduous efforts to learn Persian and pass himself off as a Jew, since Christians are treated with hostility in the Muslim lands he is about to enter. Refused at first at Avicenna’s school, he finally receives help from the Shah and becomes a star student. His medical education culminates in travel as far as India, and illegal ventures into the body as he dissects the dead under cover of darkness. Ultimately he marries the daughter of a Scottish merchant he had met but parted with in his outgoing journey, and, fleeing the dangers of war, returns with her and their two sons to the British Isles, where he sets up practice in Scotland.
Summary:Born into a Montreal Jewish family in 1924, Richard Goldbloom was always sensitive to minorities and at ease with difference. Jewish and Christian, French and English, music, theatre, and the arts in all forms were prevalent and valued in the family home. He became a skilled pianist and a gifted storyteller. Richard trained in medicine with his father and at McGill University then specialized in pediatrics at Harvard with the famous Charles A. Janeway at Boston Children’s Hospital.
Summary:This memoir focuses on the various ways in which his being an African American affected Tweedy’s medical education and early practice as a medical resident and later in psychiatry. Raised in the relative safety and privilege of an intact family, he found himself underprepared for some of the blatant forms of personal prejudice and institutional racism he encountered in his first years of medical education at Duke Medical School. One shocking moment he recounts in some detail occurred when a professor, seeing him seated in the lecture hall, assumed he’d come to fix the lights. Other distressing learning moments occur in his work at a clinic serving the rural poor, mostly black patients, where he comes to a new, heightened awareness of the socioeconomic forces that entrap them and how their lives and health are circumscribed and often shortened by those forces. Well into his early years of practice he notices, with more and more awareness of social contexts and political forces, how the color line continues to make a difference in professional life, though in subtler ways. The narrative recounts clearly and judiciously the moments of recognition and decision that have shaped his subsequent medical career.
Summary:Not God is a "play in verse" with two characters, a hospitalized patient and the patient's doctor. The scare quotes indicate the fluid quality of Not God, which the author originally conceived as a sequence of poems spoken in a patient's voice. Subsequently, he added the doctor poems (monologues) to create a "dialog" between the two voices. Once again, scare quotes suggest the atypical quality of this dialogue, since the two characters express different feelings and perspectives on the situation, but do not directly address one another. The play version has received several performances at colleges and small theaters.The patient speaks first in a monologue that begins "A man's cough bounces down the hallway / like pick up sticks... " and ends with "I am here two weeks." (p. 7) It soon becomes evident that he/she has cancer and is receiving chemotherapy. The doctor has changed this person's life by speaking "one word," after which "nothing / would ever be the same again." (p. 10). The patient is knowledgeable, accepting of his/her condition, a keen observer with a good sense of humor, as in "Doldrums" (p. 19) and "Cricket" (p. 23), and a person who affirms life in spite of adversity. The doctor is burdened with the power of medical knowledge. In particular, he understands the deadly meaning of signs and symptoms: "We say / excess water and swelling of the belly, knowing / full well... / an ovarian cancer is almost certain." (p. 33) But the meaning this represents is chaos: there is nothing humane or transcendent about cancer. Unlike his baseball card collection in childhood ("Shoebox," p. 35), cancer is neither confined nor orderly. In the second act, the patient sympathizes with the doctor whose "head is so cluttered / with obligatory data." Paradoxically, the doctor must be protected because he is "filled with dying." (p. 41) The doctor becomes angry with the burden, "Why / ask me a question that only God can answer?" (p. 49) and cries out that his work is "alchemy, / potions and witches' brews." (p. 54) In the end, while dying, the patient imagines "a bridge that can cross / the Atlantic." (p. 68), while the doctor speaks a prayer, "The word cure, dear God, is always / near my lips, though I have been constrained from / saying it aloud." (p. 66)
Summary:In this collection (80 pages), Marc Straus speaks of the inadequacy of communication and knowledge in medicine; the pauses, the distance, the hesitations. You think you know what you are doing, "But no, they always ask the question / I never knew." ("The Log of Pi") "The question / might be so simple, so clear / that you’re unprepared to answer." ("Questions and Answers") Though words are in one way inadequate, the medical word carries great power: " . . . I knew that moment / I would say one word for her and nothing / would ever be the same again." (One Word, annotated in this database.)The poet comes to understand that he represents both sides of medicine, both the detached and distant Dr. Gold, and the warm and trustworthy Dr. Green. (See annotation of Dr. Gold & Dr. Green) Unfortunately, this knowledge only comes about after the patient has died ("Dr. Gold & Dr. Green, II"). We learn from experience, sometimes too late.
Summary:The speaker reflects that "life is sometimes reduced / to a single word . . . . " He remembers one incident at a bus stop, another interviewing a man "for a job in my lab." Then there was the time a woman "walked / into my office for one thing . . . . " He discovered a "fullness" in her neck and knew that the word he would say to her, the one word, would change her life: "nothing / would ever be the same again."