Showing 31 - 40 of 250 annotations tagged with the keyword "Medical Education"

Anatomy Lesson

Coulehan, Jack

Last Updated: Oct-06-2015
Annotated by:
Aull, Felice
Chen, Irene

Primary Category: Literature / Poetry — Secondary Category: Literature / Poetry

Genre: Poem

Summary:

This poem describes how, during the anatomy lesson, the medical student feels curiosity about the wonders of the human body. He is torn between his desire for knowledge and the horror he feels in cutting up a dead body: "the violence of abomination." This marks a transitional point in the student’s medical career path.

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Pathology of Colours

Abse, Dannie

Last Updated: Oct-06-2015
Annotated by:
Shafer, Audrey

Primary Category: Literature / Poetry

Genre: Poetry

Summary:

In this haunting poem, Abse compares the colors found around us to colors found in illness and death. The poem begins prettily, "I know the color rose, and it is lovely," an image which is immediately juxtaposed with a tumor ripening into the same color. Similarly in the same quatrain, another image of nature, "healing greens", is compared with "limbs that fester" of the same color. To emphasize the tension of the similarity and difference, Abse ends the two lines with the same word. However, the nature image is "so springlike," while the illness image is "not springlike."By the second quatrain, the images become more grotesque and frightening, as the colors of "the plum-skin face of a suicide" and the "china white" eyes or figure of a car accident victim are described. In the following quatrain, the tensions mount, as "the criminal, multi-coloured flash / of an H-bomb" is described as "beautiful" and compared to the stunning and glorious image of the mesentery dissected during an autopsy: "cathedral windows never opened."The poem closes with the rainbow, seen not only in the sky, but also in "the bevelled edge of a sunlit mirror," as well as in the striped "soldier's ribbon on a tunic tacked." Life and death, nature and pathology, health and illness are hence all united by common colors; colors which are reflected in that "sunlit mirror."

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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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A Dublin Student Doctor

Taylor, Patrick

Last Updated: Aug-14-2015
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

In 1965, Dr Fingal Flaherty O’Reilly is traveling in his car with nurse Kitty when they come across a road accident and stop to help. The incident leads to reminiscing about his final years of medical training in Dublin hospitals in the 1930s.

Fingal has just returned from a stint in the navy. His student cohort includes a steady chum, a respected, brilliant woman, and a narcissistic pest–-all rather familiar tropes, comfortably portrayed. A picture of a hospital-based education emerges through teachers both kindly and rigid, a crusty head nurse who turns out to be a good soul, and a lovely student nurse, Kitty. Fingal’s professorial father disapproves of his son’s choice of a medical career and on his infrequent visits home, their relationship is tense.

Attractive to medical student readers are the clinical stories, the diagnostic dilemmas, and the stress of examinations. Social factors, such as poverty, unemployment, and discrimination, are intimately connected to the health of Fingal’s patients both as causes and results. His concern for his patients and those aspects of their lives earn him the respect of the head nurse and her student
.   

This story set in two time periods is partly a prequel to some of Taylor’s other tales, such as An Irish Country Doctor.

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Doctor Death

Kaaberbøl, Lene

Last Updated: Aug-07-2015
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

In 1894 France, Madeleine Karno hopes to follow in her father’s footsteps as a pathologist. She is passionate about medicine and especially about science and how it can help the dead 'speak.' When a young girl is found lifeless outside her own home, the autopsy can find no evidence of murder; however, the discovery of tiny mites in her nostrils leads Madeleine and her father on a lengthy investigation involving the girl’s family, a priest, abused children, and a convent school that has a three-hundred year tradition of keeping wolves.

By the end, the story is littered with corpses, each needing careful pathological inspection. Madeleine is chillingly threatened, but she lives and justice prevails.  

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Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Matthew McCarthy begins his memoir of medicine internship year at Columbia University with a glimpse into his first rotation, surgery, as a Harvard medical student. He had exhibited a talent for surgery and liked it – an affinity compatible with his dexterity as a minor league baseball player and sense of team spirit. The reader meets some of McCarthy’s memorable mentors, and, although he opts to not pursue surgery as a career, McCarthy’s eye for seeking productive apprenticeships with talented housestaff and faculty allow him to guide the reader through a year of drinking from the firehose, also known as internship. Medical training is full of liminal experiences, and internship is one the most powerful and transformative.  

McCarthy’s eagerness to do well, both by his patients and by his medical colleagues and team, and his candor with revealing his mental and bodily responses to the stress and strain of the responsibilities of internship, make him an adept guide. For example, he has gulped an iced coffee and is churning at the bit to take care of a new admission on his first day of call in the cardiac care unit (CCU). His resident, called Baio in the book, tries to tell McCarthy to take it easy. But McCarthy notes, “Our orientation leaders, a peppy group of second- and third year residents, had instructed us to exude a demented degree of enthusiasm at all times, which wasn’t difficult now that my blood was more caffeine than hemoglobin.” (p 15) The previous chapter had ended with a cliffhanger – a patient life would be placed in danger because neophyte McCarthy misses the importance of a key clinical finding – what and how that plays out will wait until McCarthy guides us through the terror and exhilaration he feels as he begins his CCU rotation.  

McCarthy has a good sense of the ironic: the huge banner advertising the hospital reads “Amazing Things are Happening Here!” Indeed, not only for patients and families, but also for the many trainees and workers. We watch McCarthy successfully perform his first needle decompression of a pneumothorax; he is allowed to attempt it as he notes that he watched the video of the procedure. But unlike the video, he needs to readjust the needle several times and add on some additional tubing and water trap, which makes the scenario more true-to-life than a fictionalized ‘save.’ The author ends the chapter with congratulations from resident Baio: “Well done… Amazing things are indeed happening here.” (p 244) As McCarthy’s year continues, many things do happen, including an infected needle stick, telling bad news to a new widow, and developing a friendship with a longterm hospital patient waiting for a heart transplant.

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Annotated by:
Miksanek, Tony

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

A bicycling, bee-keeping, British neurosurgeon approaching the end of his professional career recalls some distinctive patients, surgical triumphs as well as notable failures, difficult decisions, and mistakes. Nearly thirty years of a busy neurosurgical practice are distilled into a collection of linked stories throbbing with drama - both the flamboyant kind and the softly simmering type.

Most chapters are titled after a medical condition (exceptions are "Hubris" and "Melodrama"). Some of the headings are familiar - Trauma, Infarct, Aneurysm, Meningioma. Other chapter titles flaunt delicious medical terminology that mingles the mysterious and the poetic with nomenclature such as Angor animi, Neurotmesis, Photopsia, and Anaesthesia dolorosa.

Included are riveting accounts of both mundane and seemingly miraculous patient outcomes. One success story involves a pregnant woman losing her sight due to a brain tumor that compresses the optic nerves. Her vision is restored with an operation performed by the author. Her baby is born healthy too. But tales of failure and loss - malignant glioblastomas that are invulnerable to any treatment, operative calamities including bleeding of the brain, paralysis, and stroke - are tragically common. The author describes his humanitarian work in the Ukraine. He admits his aggravation with hospital bureaucracy and is frequently frustrated by England's National Health Service.

Sometimes the shoe falls on the other foot, and the doctor learns what it is to be a patient. He suffers a retinal detachment. He falls down some stairs and fractures his leg. His mother succumbs to metastatic breast cancer. His three month old son requires surgery for a benign brain tumor.

As his career winds down, the author grows increasingly philosophical. He acknowledges his diminishing professional detachment, his fading fear of failure, and his less-hardened self. He becomes a sort of vessel for patients to empty their misery into. He is cognizant of the painful privilege it is to be a doctor.

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Annotated by:
Donley, Carol

Primary Category: Literature / Poetry — Secondary Category: Literature /

Genre: Poetry

Summary:

Bursting with Danger and Music  reveals Jack Coulehan’s  characteristic sensitivity to contradictions, tensions, and creative energy. The book is divided into six sections, thematically held together with such headings as “All Souls’ Day” and “Levitation.”  Many of the poems are first person narrations by patients,  physicians, and observers of the natural world.  Sometimes the patients are near death, as in “Darkness is Gathering Me” and “Slipping Away,” where they observe their own dying without fear but with wonder and even a sense of celebration:   “I’m pouring through the pores/ of this room, I’m already/ feeling the jazz and hormones begin” (p. 39). In “The Internship Sonnets,” he experiences the world of the medical intern, often scared and exhausted, who is caught between his subservient duty to the chief of medicine and his own violations of that duty, such as telling the truth to patients.  Where is his primary duty?  What ought he to do in these conflicting value systems?

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Summary:

This anthology is a sequel to Pulse: The First Year (2010). Both anthologies are comprised of postings to the website “Pulse: voices from the heart of medicine,” an online publication that sends out short poems and prose pieces every Friday. As the website subtitle suggests, the topics are from the medical world, the writing is personal (not scientific), and the writers give voice to feelings and perceptions from their direct experience as care-givers, patients, or family members of patients. All the pieces are short (typically one to five pages), usually with a tight subject focus. For example, in "Touched," Karen Myers reports how massage has helped her muscular dystrophy. 

The postings in the second anthology originally appeared from April 2009 through December of 2010. Because the 87 pieces appear in the order they were published, they don’t have linear coherence. Therefore the editors of have thoughtfully provided four indices in the back of the book: by author, by title with summaries, by healthcare role, and by subject/theme.

Prose pieces vary widely in style and technique. The poems are almost all free verse, although some poets have used regular stanzas. “Depression Session,” (p. 157) is an 18-line poem by a physician about a difficult mental patient. Many of the pieces explore the intensity of medical subjects with impacts on doctor, patient, and/or family. Some of them show limits of medicine. “Pearls before swine” (p. 191) relates the experience of a third-year medical student in a rotation at the office of a racist and sexist physician. “Babel: the Voice of Medical Trauma” (p. 158) dramatically tells the story of a poorly handled birth at a hospital.  

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What the Dying Heart Says

Toomey, John

Last Updated: Feb-16-2015
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The nameless narrator has been hospitalized for months. A terrible accident while driving his Jeep. He survived, more or less. The other occupants of the vehicle - his wife and two children - did not. He watched them die. A traumatic brain injury and locked-in syndrome have left him unable to communicate. Although his body is useless, he assures us that he is completely lucid and resentfully aware of his circumstances. He desperately wants to die and admits, "I am already dead with grief" (p. 245).

The medical team caring for him won't call it quits. The narrator's brother, Tommy, informs them that his sibling would not wish to be kept alive in his current condition. But Professor Carson, the attending physician, insists that treatment will continue because the patient is not dead. Only one doctor, a compassionate Croatian female intern, comes forward as an ally of the narrator. She wonders out loud, "What man would want to live? Now?" (p. 242).

Even as the narrator's physicians prepare him for a brain-computer interface, he voicelessly implores Tommy to "convince these bastards to let me go" (p. 244) - to no avail, of course. Dying of a broken heart and helplessly being kept alive despite a shattered one, the narrator is doomed to a survival he does not want and to remembering the gruesome loss of his family that he cannot escape.

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