Showing 321 - 330 of 425 annotations tagged with the keyword "Professionalism"

Summary:

Kirklin, a physician and Lecturer in Medical Humanities at the Royal Free and University College Medical School, and Richardson, a historian and associate at the Wellcome Trust Centre for the History of Medicine, are both educators in medical humanities in London. This well-written and concise volume focuses on "the role of the humanities in medical education" and is aimed at "those wishing to integrate medical humanities into their own teaching, and learning." (p. xv) The chapters are written by a variety of educators with a wide range of backgrounds, including artist, medical student, writer, nurse, surgeon and philosopher.

At least two stimuli are cited as reasons for the development of this book: (1) the 1993 publication by the General Medical Council of Tomorrow's Doctors which recommends the inclusion of medical humanities in the required curriculum for undergraduate medical education in the UK and (2) a national conference, "The healing arts: The role of the humanities in medical education" in London, March, 2000. The rationale for such a book is delineated in several prefatory statements including remarks by Professors Sir David Weatherall and Sir K. George M. M. Alberti (Alberti is the president of the Royal College of Physicians). The book concludes with recommendations for further reading, schemata for undergraduate and graduate degrees in medical humanities at University of Wales, Swansea, and an index.

The nine chapters in this volume combine pedagogic philosophy, citations for literature and art and how to encourage reflection about these selections, tools for encouraging student creativity, reproductions of art and literature generated by students or patients or used by teachers for discussion, and some practical advice about teaching medical humanities and its, at times, uneasy connection to the rest of the curriculum. Each chapter reflects the individual contributor's area of expertise and experience. For example, in "Fostering the creativity of medical students", the authors Heather Allan, Michele Petrone (who painted the striking cover art), and Deborah Kirklin provide useful guides for teaching creative writing and art production by students studying cancer and genetic disease.

In a particularly insightful chapter, "Medical humanities for postgraduates: an integrated approach and its implications for teaching," Martyn Evans describes the challenges of developing a full-fledged interdisciplinary program for graduate as well as undergraduate studies in Wales. He addresses concerns about "bolt-on" versus integration of medical humanities in the curriculum, risks of superficiality, and how such studies may transform the culture of modern medicine. Several chapters address a theme (such as "clinical detachment" or understanding the patient's perspective) and include topic-specific sources and guidelines.

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Annotated by:
Shafer, Audrey

Summary:

Levin, a social documentary photographer, immersed herself with the Class of 2001 in the anatomy course at Weill Medical College of Cornell University. Her photographs of cadavers, students and instructors are prefaced by a foreword by physician-writer Abraham Verghese. He describes the rite of passage of anatomical dissection: "The living studying the dead. The dead instructing the living." (p. 9)

Interspersed with the full-color images are journal entries by 11 medical students and several artistic anatomic illustrations by 3 of the students. The journal entries and photographs are organized temporally, from the introduction to the dissection lab to the final exam and student-organized memorial service. The end of the book includes the interests and brief biographies of the 11 students and a final dedication by Levin of the book to those who donated their bodies: "I have never before witnessed a gift that is honored, respected, and consumed so completely."

The photographs are not for the squeamish. For example, the double amputee pelvis prosection on page 102, or the multiple images of flayed skin, bits and pieces, or limbs tied to supports provide an insider's view of an anatomy course. Many of the images show the living in motion: translucent images of students in time-lapse swirl near the static cadavers. Other images conjure the once-upon-a-time personhood of the dead: pink fingernail polish on a female cadaver or a heart palmed by a student. The intensity of the student experience is well documented, as is the relaxed atmosphere that inevitably develops as students become accustomed to the experience of dissection.

The student journal entries are sensitive and thoughtful. Students comment on the intersections of daily living, home life, and their own bodies and bodily functions with what they are learning in the classroom. Particular discomfort regarding certain dissections, such as the pelvic region, are acknowledged. Even though students note growing immunity to the dissection experience, such comments reflect insight into professionalism and defense systems. Gallows humor and uneasiness with such humor is explored by Rebecca (p 62) after she sings "New York, New York" to the roomful of cadavers. Forensic clues about the cause of death for a particular cadaver renew the sense for students that this was once a living, feeling person.

The intense, long hours required for understanding and memorizing the material are clearly evident, but ultimately, these students realize they are given a truly special opportunity: "I began to love learning the material just for the sake of learning. Anatomy no longer felt like a burden, but rather a gift." (David, p. 119) Relationships explored include those of student with cadaver (particularly respect/disrespect, ownership and protection), life with death, and those who have had the experience of dissection with those who never will.

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Annotated by:
Shafer, Audrey

Primary Category: Visual Arts / Photography

Genre: Photography

Summary:

Levin, a social documentary photographer, immersed herself with the Class of 2001 in the anatomy course at Weill Medical College of Cornell University. Her photographs of cadavers, students and instructors are prefaced by a foreword by physician-writer Abraham Verghese. He describes the rite of passage of anatomical dissection: "The living studying the dead. The dead instructing the living." (p. 9)

Interspersed with the full-color images are journal entries by 11 medical students and several artistic anatomic illustrations by 3 of the students. The journal entries and photographs are organized temporally, from the introduction to the dissection lab to the final exam and student-organized memorial service. The end of the book includes the interests and brief biographies of the 11 students and a final dedication by Levin of the book to those who donated their bodies: "I have never before witnessed a gift that is honored, respected, and consumed so completely."

The photographs are not for the squeamish. For example, the double amputee pelvis prosection on page 102, or the multiple images of flayed skin, bits and pieces, or limbs tied to supports provide an insider’s view of an anatomy course. Many of the images show the living in motion: translucent images of students in time-lapse swirl near the static cadavers. Other images conjure the once-upon-a-time personhood of the dead: pink fingernail polish on a female cadaver or a heart palmed by a student. The intensity of the student experience is well documented, as is the relaxed atmosphere that inevitably develops as students become accustomed to the experience of dissection.

The student journal entries are sensitive and thoughtful. Students comment on the intersections of daily living, home life, and their own bodies and bodily functions with what they are learning in the classroom. Particular discomfort regarding certain dissections, such as the pelvic region, are acknowledged. Even though students note growing immunity to the dissection experience, such comments reflect insight into professionalism and defense systems. Gallows humor and uneasiness with such humor is explored by Rebecca (p 62) after she sings "New York, New York" to the roomful of cadavers. Forensic clues about the cause of death for a particular cadaver renew the sense for students that this was once a living, feeling person.

The intense, long hours required for understanding and memorizing the material are clearly evident, but ultimately, these students realize they are given a truly special opportunity: "I began to love learning the material just for the sake of learning. Anatomy no longer felt like a burden, but rather a gift." (David, p. 119) Relationships explored include those of student with cadaver (particularly respect/disrespect, ownership and protection), life with death, and those who have had the experience of dissection with those who never will.

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The Talking Cure

Busch, Frederick

Last Updated: Nov-01-2001
Annotated by:
Aull, Felice

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Narrated in the first person, the transforming events of Peter's life as a 15 year old are told years later. The opening paragraphs set the scene: "the older brother who went off to school" leaving "the brilliant . . . mother . . . bereft"; the father, "son of a bankrupt Hudson Valley apple grower"; "the darkening drift and dismay of my parents." Into this family unease steps the local veterinarian, Dr. Mason, whom Peter assists during after-school hours, and who is a sometime dinner guest in his parents' home.

Dr. Mason not only tries to persuade Peter to go into a medical profession, ignoring Peter's interests (writing poetry, reading about mountain climbing) but self-importantly insists on "offering [him] lessons in nothing less than all of life" (63). Dr. Mason, we learn, is singularly unqualified to dispense such lessons. He is, at least in Peter's eyes, overbearing and insensitive in his interactions with the owners of the pets he treats, and perhaps even unethical in his professional decisions. Then, Peter discovers, his mother is having an affair with Dr. Mason (who is also married). It is the burden of this knowledge that drives the narrative.

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An X-Ray of Longing

Downie, Glen

Last Updated: Oct-17-2001
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

The first full-length collection of poetry by a Canadian medical social worker who cares for cancer patients and their families. The "longing" of the title expresses the human yearning for love, knowledge, completeness, and healing.

Many of these poems deal with the process of revealing the inner workings of the world (and the inner truth of persons) through photography; see "Darkroom: 1," in which, "I watched you emerge / take on form / and intensity." X-ray photography, of course, takes this one step further, allowing us to see the insides of bodies.

The long last section of the book includes 24 poems that deal explicitly with illness and health care. Among the best of these are "Worker Classification: Material Handler," "Hand to Mouth," "Wishbone," and a sequence of short poems called "Post-Mortem Report."

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Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Collection (Short Stories)

Summary:

This is a collection of humorous sketches first published in 1850. They purport to describe the youthful experience (and antics) of an elderly "swamp doctor" named Dr. Madison Tensas. In fact, they are the work of Henry Clay Lewis, a young Jewish-American doctor who, after graduating from the Louisville Medical Institute in 1846, set up practice in MADISON County, Louisiana, along the banks of the TENSAS River.

The Introduction of this edition, written by Edwin T. Arnold, locates Henry Clay Lewis and his work within the context of 19th Century "South and Southwest Humor," and briefly discusses each piece. One of his major points is that the swamp doctor's "odd leaves" contain a dark, almost Gothic strain, thoroughly mixed in with their humorous and prankish sensibility. (Perhaps "lack of sensibility" would be a better phrase to use to describe these sketches.)

The first brief sketch compares characteristics of the "city physician" with the "swamp doctor." After this, we follow the growth and development of "Dr. Tensas" from childhood through medical school and into his practice in the swamp country of Louisiana. Among the more notable sketches are "Getting Acquainted with the Medicine," in which the student's preceptor conceals his bottle of whiskey by labeling it "tincture of arsenic"; "The Curious Widow," in which the student prepares a gristly surprise for his snooping landlady; "Being Examined for My Degree," which demonstrates the comic vagaries of oral examinations; "My First Call in the Swamp," in which the newly minted doctor cures his first patient (more or less); and "How to Cure Fits," which presents a novel and efficient treatment for hysterical disorders.

If you want to find some genuine clinical wisdom in this book, look no further than "My First Call in the Swamp," where the author observes, "if you wish to ruin yourself in the estimation of your female patients, hint that the disease they are laboring under is connected with hysterics" (p. 146).

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Baptism by Rotation

Bulgakov, Mikhail

Last Updated: Aug-22-2001
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

A young doctor, recently assigned to a country hospital, is fraught with anxiety, especially over his lack of experience with obstetrical problems. One night the midwives call him; a woman is having a difficult labor. The fetus is presenting in a transverse position. The doctor must reach internally and “turn it around by the foot,” as Anna Nikolaevna, the seasoned midwife, reminds him.

The doctor has never performed this procedure. He buys time by going back to his room to consult the textbook (under the pretext of going for cigarettes). Finally, he can't avoid it any longer. He performs the rotation. It works! Both mother and baby are saved.

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Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Autobiography

Summary:

This brief autobiography, written when Schweitzer was mid-50's, summarizes his life and thought up to 1931. He presents illustrative factoids and incidents from his childhood and student years, then briskly covers his development as a minister, philosopher, biblical scholar, musician, and musicologist, all before he reaches Chapter 9 (p. 102), which is entitled, "I Resolve to Become a Jungle Doctor." He greatly enjoyed his life as a scholar, yet was plagued by "the thought that I must not accept this happiness as a matter of course, but must give something in return for it." (p. 103)

He was particularly struck by the fact that so many people in the world were "denied that happiness by their material circumstances or their health." At around this time (1904), Schweitzer came across a publication of the Paris Missionary Society, which described the needs of their Congo mission. This article changed his life. In 1905, at the age of 30, he enrolled in medical school at the University of Strasburg. (Thus, Schweitzer became a forerunner of today's nontraditional applicants who leave other promising careers to enter medicine.)

Schweitzer and his wife began their work at Lambaréné in Gabon, West Africa, in 1913. As a result of the Great War in late 1917, they were sent back to France and detained as enemy aliens until mid-1918. They returned to Lambaréné and rebuilt the hospital in 1924. Between then and 1931 when Out of My Life and Thought was written, Schweitzer devoted most of his time (as he would for the rest of his life) to doctoring at his hospital in Gabon.

This memoir also includes brief intellectual asides describing many of Schweitzer's famous works, such as The Quest of the Historical Jesus (1906), J. S. Bach (1908), On the Edge of the Primeval Forest (1920), Philosophy of Civilization (1923), and The Mysticism of Paul the Apostle (1930).

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A Winter Visit

Abse, Dannie

Last Updated: Aug-17-2001
Annotated by:
Woodcock, John

Primary Category: Literature / Poetry

Genre: Poem

Summary:

The poet-doctor-son takes his ninety-year-old mother for a walk through the park on a cold winter day. He cites the peacock as an emblem of life-spirit, but she responds by talking about dying, saying: "This winter I'm half dead, son." He wants to weep, but does not allow himself to, because he "inhabit[s] a white coat." He avoids the issue by speaking of "small, approximate things."

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Summary:

This memoir begins in Africa, where Dr. Grim is with Médecins sans Frontières managing a meningitis outbreak in Nigeria. Conditions are appalling, but she has come here because of burnout: "so I won't be back home and in the ER" (11). Later in the book, she describes her other "escapes" from the Emergency Room, caring for war refugees in the Balkans.

The book centers, however, on life in an American emergency department, as Grim remembers it from the vantage point of Africa (where she does eventually become nostalgic for well-stocked supply cupboards and a more comprehensible chaos). She organizes her stories into a series of "Lessons in Emergency Medicine," in which she addresses the reader directly. After going through a step-by-step account of death in the ER, illustrated with several moving and alarming cases, she concludes: "Congratulations: you have successfully declared someone dead. Now, as an encore . . . you'll get to do it all over again" (28).

The ironic, even bitter, tone warns us of the difficulty of working in such perpetually crisis-ridden circumstances, but it does not conceal a vulnerability that seems necessary to doing the job well, such as when Grim has to tell a family that the father has died of the heart attack he had at his daughter's wedding: "you just stood there," she says, "looking at the corsage, the tuxedo and the pearls . . . You had no idea what to say and you don't really remember what you finally came out with" (26).

The stories are organized around several lessons: "How to deliver a baby," "How to crack a chest," "How to write a prescription" (which includes a discussion of addiction to prescription medication and a withering account of the doctor who overprescribes), and, as if it's as inevitable as the rest, "How to burn out."

By the book's final chapter, emergency medicine has merged, along with the vaccination of refugee children and the impossibility of treating tetanus in Nigeria, into the story of almost unreasonable determination in the face of endless frustration--but this, Grim shows in her final chapter, "Why I do what I do," is the point. Against this backdrop her final story, about the rescue of a child, makes its point: the feeling of saving a life explains all the rest.

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