Showing 31 - 40 of 492 annotations tagged with the keyword "History of Medicine"

The Physician

Gordon, Noah

Last Updated: Nov-17-2015
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel

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.

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Annotated by:
Miksanek, Tony

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

This thoughtful essay from the author of The Emperor of All Maladies expounds on information, uncertainty, and imperfection in the medical setting. The author recalls witnessing a difficult operation when he was a medical student. The attending surgeon admonished the operating room team, "Medicine asks you to make perfect decisions with imperfect information" (p.5). This essay is constructed around that idea as the author shares three personal principles that have guided him throughout his medical career.
     Law One: A strong intuition is much more powerful than a weak test. (p. 22)
     Law Two: "Normals" teach us rules; "outliers" teach us laws. (p. 38)
     Law Three: For every perfect medical experiment, there is a perfect human bias. (p.54)

He views the medical world as a "lawless, uncertain" place and stresses that biomedicine is a "softer science" than chemistry or physics. Clinical wisdom, in his opinion, is imperfect, fluid, and abstract whereas the knowledge base of other basic sciences is concrete, fixed, and certain. He laments, "My medical education had taught me plenty of facts, but little about the spaces that live between facts" (p. 6).

His own "laws" of medicine are actually laws of imperfection. Clinical diagnosis can be thought of as a "probability game" where human bias creeps into the process. And ultimately common sense trumps pure statistical reasoning. Woven into the discussion are considerations on a variety of topics - children with autism, Heisenberg's uncertainty principle, genomics, radical masectomy, and randomized, double-blind studies. Nods to Lewis Thomas (The Lives of a Cell: Notes of a Biology Watcher), Thomas Bayes (Bayes' Theorem), and Johannes Kepler (Kepler's Laws of planetary motion) fit in nicely with the thrust of the treatise.


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A Lucky Life

Goldbloom, Richard

Last Updated: Nov-11-2015
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Nonfiction

Genre: Autobiography

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.

He met the vivacious, intrepid Ruth Schwartz at McGill when they both auditioned for a play. Also Jewish, she hailed from Cape Breton Island, Nova Scotia. They married in 1945 before his studies were complete and had three children. Unlike many male physicians of his era, Richard was in awe of this tiny dynamo and attributes his happiness and success to her.

In 1967, the family moved to Halifax, Nova Scotia, where Richard became Professor of Pediatrics, Physician in Chief and director of research at the new children’s hospital. Ruth was instrumental in a wide array of philanthropic endeavors that inevitably involved her husband. She developed a remarkable museum at Pier 21, the point of arrival for generations of immigrants to Canada—a place to gather their stories and their achievements.

Many anecdotes about clinical practice and scientific innovations are told with accessible enthusiasm and gentle humor. He dispels myths, exposes hidden agendas and explains with clear examples the importance of listening to children and their parents. Underlying the entire narrative is a refreshing humility and gratitude for his “lucky life.” 

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Will Starling

Weir, Ian

Last Updated: Oct-16-2015
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

In 1816 London, Napoleon has been defeated and troops have returned, including teenaged Will Starling, who survived the wars as assistant to the decent surgeon Alec Comrie. Will now serves Comrie in the city, still in strained circumstances.

Medical science has turned to the utility of anatomy, but material for research and teaching is scarce. Body-snatchers procure subjects from robbing graves—sometimes from murder—but they are not the only bad actors. Flamboyant, privileged Doctor Dionysius Atherton is trying to raise the dead by applying newly harnessed electricity to fresh cadavers.

From this ghoulish world of science and crime, young Will Starling tells his own tale, as your “Wery Umble Narrator.” Vivid scenes of wretched urban poverty, wanton cruelty, and selfless heroism march past to a grim ending.  

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The Normal Heart

Kramer, Larry

Last Updated: Oct-06-2015
Annotated by:
Glass, Guy

Primary Category: Literature / Plays

Genre: Play

Summary:

New York, 1981.  As the play opens, Ned Weeks sits outside a doctor’s office with a friend who has developed worrisome symptoms of a mysterious “plague” that strikes homosexuals.  The doctor, Emma Brookner, complains that she cannot make headway in getting the gay community to take the threat seriously.  This encounter inspires Ned, a writer, to dedicate himself to becoming the spokesman for the growing ranks of disenfranchised patients. He attempts to convert others to his cause, including his heterosexual brother, a closeted bank executive, and a reporter for the New York Times (whom he begins to date).  When it becomes clear that the City is not interested in assisting, he co-founds a grassroots activist organization.  As the epidemic veers out of control, the man he loves falls ill as well.  Over time, Ned’s abrasive, confrontational approach, as well as his focus on abstinence, makes him many enemies within the gay community.  Ultimately, he is forced out of his own organization.  At the same time, there are hints that, as a result of his work, the disease is beginning to be taken seriously.  At the end of the play, Ned’s lover Felix becomes the latest gay man to succumb to the epidemic. 

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Summary:

This poem is told in the voice of the quack who creates electronic gadgets that are supposed to cure illnesses. He advertises on the back covers of magazines. Poor, desperate people, whose doctors cannot help them, sell their farms in order to come to the quack for his dynamizer and oscilloclast treatments. He asks, "What could I do but give them hope?"

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Annotated by:
Donley, Carol

Primary Category: Literature / Poetry

Genre: Poetry

Summary:

This poem compares the grave robbing done in the 19th century in order to provide cadavers for medical training and research with the modern medical technologies that "rob" the dead of their rest by keeping them alive on machinery. Now the medical profession is "resurrecting" people before they're dead--delaying their deaths with machinery and drugs. "We cheat the dead of dying, with machines instead of spades." This poem also comments on the use of poor people who don't have the power to prevent this kind of denial of their rights.

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Welcome to Cancerland

Ehrenreich, Barbara

Last Updated: Sep-28-2015
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

A “drive-by mammogram” leads the writer, Barbara, to a biopsy of a suspicious breast lump. She awakes from the fog of anesthesia to hear the surgeon’s bland remark: “Unfortunately, there is a cancer.” Welcome to Cancerland, a place where her identity is displaced by the vast implications of the diagnosis, another operation, and arduous months of chemotherapy. What works for her own peace of mind has little to do with the trappings of pink-ribbon sentimentalism in the survivors groups.

Barbara resorts to her knowledge of cell biology, asks to see her own tumor under the microscope, and contemplates the meaning of visualizing the malignant cells even if she does not believe the exercise can help her. She dissects the rank commercialism and denial in the survivor movement: let me die of “anything but the sticky sentimentalism in that Teddy Bear.” She decries the claims that cancer therapy makes better skin, better hair, and better people, with better bodies, especially when an implant on one side subtends a cosmetic procedure on the other.

Posting these thoughts on a chat line, she discovers that most women berate her attitude and suggest she needs a psychiatrist. But one dying woman agrees with her distress, and writes of having cancer, “IT IS NOT OK.” Admitting feminists can be found in the “survivor” community, Barbara faults its underlying tone for being coercively optimistic, infantilizing, and insulting to the dying and the dead. She is angry. Very angry, and her “purifying rage” spares no one: doctors, support groups, feminists, drug companies, and the Cancer Society. Nevertheless--and in keeping with her earlier work--she credits the women’s movement with helping to rid the world of three medical evils: the radical Halsted mastectomy, the practice of proceeding to mastectomy from biopsy without waking up the patient, and high dose chemotherapy.

Two disturbing ironies bring the essay to a close. The first, is the possibility that mammograms may not be saving or even prolonging lives, even as they detect cancers; they make women dwell in Cancerland for longer and cause too many “unnecessary” biopsies. The mammogram is a ritual, she says. The second irony lies in the role of the pharmaceutical industry which fosters the pink power movement –the ribbons, the teddy bears, the marathons-- while manufacturing the expensive poisons that seem to have anticancer side effects. These same companies, she argues, have also manufactured carcinogenic pesticides that pollute the environment. Having profitably poisoned women into having breast cancers, they continue to profit from poisons of chemotherapy.
She faults both the “cult” of the survivors movement and the American Cancer Society for their “unquestioning faith” in these imperfect instruments of action.

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The Burying Ground

Kellough, Janet

Last Updated: Sep-21-2015
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Luke Lewis is the son of an itinerant preacher in Upper Canada and a recent medical graduate of Montreal’s McGill University. In 1851, he joins the practice of the aging, Edinburgh-trained Dr. Stewart Christie in Thornhill, Ontario. It is a small village a few miles north of Toronto (now the site of some of the most expensive property in Canada).  Christie is tired and leaves Luke alone to work.   

Luke hopes to consolidate his learning and earn enough to set up on his own elsewhere in Ontario, closer to his farming brothers. He rents a couple of rooms from the doctor and is able to accommodate his father Thaddeus Lewis on his occasional visits.   

Morgan Spicer, the custodian of the local Strangers’ Burying Ground, is an old friend of the family. He finds a grave disturbed, which raises the specter of grave-robbing, an all too common crime much abetted by medical schools. But in this case, the corpse is left behind and the grave was not fresh. Morgan is baffled but the police are indifferent. When it happens a second time, Luke and his father try to help solve the mystery. They wonder if Dr. Christie might be behind it. What does he do all day?   

Luke is lonely and he sorely misses his friend and lover, Ben, who died of tuberculosis back in Montreal. Luke has managed to keep his sexual orientation firmly in the closet, knowing it would be the end of his career and of his relationship with his beloved father.   

However, Luke’s gallant actions in rescuing the beautiful African, Cherub, from American slave-traders, result in an unwanted invitation from a somewhat too grateful society lady, Lavinia. Through her, he meets the clever Perry Biddulph and is plunged into a torment of attraction and despair, compounded by the fact that Lavinia’s husband is a scoundrel whom the Lewis’s have met before in the previous novel.   

Luke firmly resolves to avoid both Lavinia and Perry, but she uses his sexual secret to blackmail him into finding the means to leave her husband. Most problems are nicely resolved in the end. To say more would spoil it.  

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Medicine: My Story

Berris, Barnet

Last Updated: Aug-25-2015
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Nonfiction

Genre: Autobiography

Summary:

Born in 1921 to Jewish immigrant parents, “Barney” Barnett describes his life in medicine and education, from his earliest love of science and learning through his medical and residency education in general internal medicine, his success as an academic physician, and finally his judicious decision to retire.

An important leitmotiv is the antisemitism of the University of Toronto that kept him from a residency position (he went to Minneapolis) and a staff position (he was offered a one-year fellowship on a low salary in 1951).  Even after he was accepted as a staff member at the Toronto General Hospital (TGH), he was not promoted. Although he referred many patients to his TGH colleagues, only six ever returned the favor in the thirteen years he was there. Ironically, his Jewish background plucked him from this pedestrian position directly to the seat of Physician in Chief of Toronto’s Mount Sinai hospital (founded 1922) when finally it became a teaching hospital in 1964. 

While maintaining a practice in internal medicine, Berris became a liver specialist and researcher who introduced liver biopsy to Toronto. Known as a consummate diagnostician, he endeavored to enhance the research profile of his institution, integrating it with bedside instruction. He served on examining committees for the Royal College of Physicians and Surgeons, candidly describing the subjectivity of the process. He also served on many committees of the College of Physicians of Ontario, including discipline
, and describes the process used to investigate complaints with case examples.

His story includes vivid descriptions of some of the most famous figures in Canadian medical history, his teachers and colleagues – J.B. Grant, Arthur W. Ham, William Boyd, Ray Farquharson, K.J.R.Wightman, Arthur Squires, and Arnold Aberman. He was once involved with the care of the wife of David Ben-Gurion and Queen Elizabeth II.

Little is told of his personal life, although he admits that he often neglected his family for the press of work. His first wife, Marie, was a social worker; they had three children, one now a physician. She died of ovarian cancer; to care for her, he stepped down as chief in 1977.  In 1984, he married Thelma Rosen, an expert in education and widow of a pediatrician colleague. Together they went on a year’s sabbatical that allowed him to work in Singapore, Stanford University, and Sheila Sherlock’s lab at the Royal Free Hospital in London.

Some of the most engaging chapters contain clinical vignettes: stories about patients, the diagnostic workup, and their outcomes.  Like Richard Goldbloom (A Lucky Life
) and without diminishing his native abilities (which must have been considerable), he modestly attributes most of his success to luck.  

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