Showing 331 - 340 of 425 annotations tagged with the keyword "Professionalism"
Warren here supposedly presents the papers of a late friend, detailing the interesting cases he had encountered as a physician. In fact, the "cases" are sensational short stories, presented as a novel due to the framing chapter introducing the narrator's "Early Struggles" to make a living as a physician. Other stories investigate typically Gothic themes like ghosts, duels, graverobbing, elopements, and broken hearts, with other scandalous problems like gambling, dissipation, murder, domestic abuse, and suicide. Medical topics include mental illness, epilepsy, hysterical paralysis ("catalepsy"), cancer, toothache, consumption, syphilis, heart disease, alcoholism, disease of the spine, gout, amaurosis (blindness), puerperal hemorrhage, measles, and stroke ("apoplexy").
Narrative competence is important for effective health care practice. By "narrative competence" I mean mastering a wide array of narrative skills, ranging from active listening and empathic responding in the client-practitioner interaction to reflective writing about one's professional experience. In the author's first book (The Therapeutic Potential of Creative Writing: Writing Myself, see this database), she explores the potential of creative writing as an aspect of therapy, and also presents some introductory writing skills. This book overlaps somewhat in covering the background for reflective practice, but focuses in considerably more detail on skill building.
Near the beginning of the book, Bolton presents a clear summary of "The Principles of Reflective Practice" (chapter 2). Recognizing that therapeutic writing is often accomplished in a group setting, the material on "Group Processes and Facilitation" (chapter 4), "The Creation of a Team" (chapter 5), and "Assessment, Evaluation, Mentoring and Values" (chapter 6) serves to introduce the last 100 pages of the book, which address specific writing skills, beginning with "How to Begin Writing" (chapter 8).
The film covers two days in the life of Frank Pierce (Nicolas Cage), a burned-out EMT (emergency medical technician) working the socio-economic underside of Manhattan. From the beginning, Frank is upset because recently all his patients have been dying on him, and he is haunted throughout by the hallucinated ghost of Rose, a young woman who collapsed on the street and died, apparently because he could not intubate her correctly.
Frank is highly stressed, he has no life outside his work, and he is self-medicating with alcohol. He tries to quit, but his boss keeps him on by promising time off in the future. In the film's first action, Frank does manage to miraculously resuscitate Mr. Burke, a heart-attack victim, but the patient winds up in the hospital with a very bad prognosis, so even that "saving" works against Frank.
Frank has encounters with numerous patients, many of them street people whose lives are out of control, some of whom are ER (Emergency Room) regulars, such as the demented young Noel (Marc Anthony). He also deals with (and is dealt with by) several highly idiosyncratic EMT partners in his ambulance rounds (John Goodman and others). Frank gets to know Mary Burke (Patricia Arquette), the daughter of the heart-attack victim, and they tentatively move toward being a couple who might help each other survive their lives.
Near the end, Frank, who knows Mr. Burke had tried to tear out his tubes during a brief moment of consciousness, and who feels he has been getting pleading messages from him to end his agonies, surreptitiously takes him off life support long enough for him to die. The physician who responds to the code decides not to attempt resuscitation of this patient who had already been resuscitated 14 times that day. Frank goes to tell Mary that her father has died (but not how), and exhaustedly falls asleep on her breast, apparently having forgiven himself because he has in some sense finally "saved" Mr. Burke.
In this book Robert Coles elucidates the nature of moral leadership by presenting a series of narratives about moral leaders. These are individuals who have made significant contributions to the author's moral development, mostly through personal interaction, but in some cases through their writings or their influence on other people.
The subjects include public personages like Robert Kennedy, Dorothy Day (of the Catholic Worker), Danilo Dolci (a Sicilian community organizer), Dietrich Bonhoeffer, and Erik Erikson; writers who have influenced Coles, such as Joseph Conrad and Ralph Waldo Emerson; and "ordinary" persons whom he encountered over the years in his studies of the moral lives of children.
The "ordinary" person category is most extraordinary. Coles draws heavily on personal interviews that reconstruct the courageous narratives of people like Andrew Thomas, a young Mississippian who worked on the voter registration project during the summer of 1964; Donita Gaines, one of the first black teenagers to "integrate" an all-white high school in Atlanta in 1961; and Albert Jones, a parent who volunteered to drive the school bus that carried black children in 1967 from Roxbury to a previously all-white school in South Boston.
However, the clearest and most powerful narrative that emerges from this book is that of the author himself, as he develops from young, socially conscious child psychiatrist to a middle-aged man seeking to understand what it means to be a moral leader in today's world.
In this journal, Murray traces a month-long rotation he spends as attending physician in the ICU (Intensive Care Unit) of San Francisco General Hospital. For each of the 28 days, Murray presents the patients he sees, both new and ongoing, along with commentary on the care of each patient and on broader issues raised by their cases.
In the course of the month, we encounter sixty patients, fifteen of whom die in the ICU. The patients are apparently quite typical for the hospital: cases are dominated by HIV, pneumonia, tuberculosis, and drug abuse, or all four. The ICU is not a very safe place: there are twelve cases of iatrogenic pulmonary edema, and several of hospital-acquired infections.
Murray candidly presents both the triumphs and the limitations of contemporary intensive care while giving us vivid glimpses into the lives of both patients and staff. In his epilogue, Murray asks some tough questions about the value of intensive care units, and discusses palliative care, patients' rights to the withholding and withdrawing of life-sustaining therapy, and even physician-assisted suicide, as "more humane"--and economically responsible--alternatives to intensive care in cases of advanced terminal illness (270).
He describes the ICU as a "battleground" where people who are "clinging to life" can "fight for it" (275). This is its value. But the battles need to be better understood and winning must be carefully evaluated. Murray concludes that the last few decades' medical and technical advances in critical care now need to be matched by ethical ones.
This memoir of a clinical psychologist (also a professor of psychology) chronicles her own depression over a period of a year and a half, from early symptoms, through near despair, electroconvulsive therapy, and hospitalization to recovery. The journey is detailed, not only in its treatment of her emotional states, but of her struggle to maintain family and professional life, keep her house and office organized, and attend to a dying friend.
As her bouts of panic and disorientation grow more apparent, first to herself and finally to others, she seeks refuge in spiritual retreats and in conversation with colleagues, ultimately submitting to treatment. She names the emotional "undercurrents" suggested in the book's title with moving precision: panic over sudden disorientation, anxiety about what to keep secret, frustration with her own unreliability, dread of small duties and ordinary appointments, heartache over her faltering efforts to be a good and present mother.
The consent to hospitalization costs a great deal in humility, in risking a controversial treatment, and in letting go of a professional persona she doesn't know whether she'll be able to retrieve. But clearly the book is written by a woman whose clarity is a testimony to regained mental health and exceptional intellectual clarity. It is not a professional record, but an intensely personal memoir of what was both an encounter with serious mental illness and a spiritual journey.
By most accounts Dr. Sam Abelman is a failure in life, an irascible old general practitioner who lives in the same grimy Brooklyn neighborhood he has always lived in. He is truculent and tactless, an easy mark for the young specialists who steal his patients. One night a bunch of hoodlums drop a battered young woman on his doorstep. Abelman's nephew, a reporter, publishes a news item about the incident, "Doctor Saves Raped Girl."
Meanwhile, Woody Thrasher, vice president of an advertising agency, is looking for a new type of television show to sell to one of his clients. He comes up with Americans USA, a candid look at "ordinary" Americans who are just doing their jobs, but in an extraordinary way. He decides that Sam Abelman would be the ideal first subject.
Thrasher, a young, high-powered executive, meets Abelman, the last angry man, who summarizes his view on life by saying, "The bastards just won't let you live." The doctor's practice is declining, he can't afford to retire or move away, and the local people certainly don't seem to love him. They don't show gratitude for his services. They don't pay their bills. Many of them consider him a racist, and incompetent to boot. Abelman is clearly not a good candidate for "doctor of the year."
Yet, Thrasher soon finds himself intrigued. Abelman spends hours working in his miniature vegetable garden and reading Henry David Thoreau. He is a brilliant diagnostician, a devoted husband, and an endless campaigner against the "galoots" who think the world owes them a living. Abelman takes aim at "galoots" wherever he finds them, and he finds them everywhere.
The novel interweaves these two men's developing relationship, as Abelman agrees to do the show and Thrasher works to sell it to his bosses, with incidents from Abelman's earlier life. When it turns out that Americans USA will award its subjects their "heart's desire" (in Sam Abelman's case a new house), the doctor declines to go on, refusing to accept "charity" and claiming that Thrasher "tried to crap me up." In the end he agrees to do the show, but suffers a massive heart attack and dies.
Peppered with a plethora of black and white stills, this book is a compilation of a physician's film reviews and reflections on how movies have mirrored the changes in medical care and in society's attitudes towards doctors and medicine over the last sixty years. Ten chapters blend a chronological approach with a thematic perspective: Hollywood Goes to Medical School; The Kindly Savior:
From Doctor Bull to Doc Hollywood; Benevolent Institutions; The Temple of Science; "Where are All the Women Doctors?"; Blacks, the Invisible Doctors; The Dark Side of Doctors; The Institutions Turn Evil; The Temple of Healing; More Good Movie Doctors and Other Personal Favorites.
The appendices (my favorite) briefly note recurring medical themes and stereotypes ("You have two months to live," "Boil the Water!"). Formatted as a filmography, the appendices reference the chapter number in which the film is discussed, the sources of the photographs, and a limited index.
Harry Potter and the Goblet of Fire is the fourth book in a planned series of seven (see annotation of Harry Potter and the Sorcerer's Stone for an introductory summary). Unlike previous books, this one opens with the murder of a Muggle, Frank Bryce, the elderly gardener for the Riddle estate--a home where Tom Riddle Sr. and his elderly parents had been found dead many years before. Voldemort, although still weak and requiring much assistance from his simpering servant Wormtail and his snake Nagini, is positioning himself for a return to full power.
Harry's distinctive scar is burning with pain as he awakes from a dream of the previous scene. This scar had hurt once before, in book one, when Voldemort was on Hogwarts property. Harry alerts his godfather via owl post and joins the Dursleys for breakfast. Breakfast is meager because Dudley, always obese and obnoxious, has now grown to outrageous proportions and is on the diet ordered by his school nurse. His mother, to make him feel better, puts everyone on the same diet. Harry is once again saved from the Dursleys by the Weasley family, although Dudley and his appetite are the objects of a prank by the Weasley twins.
Arthur Weasley (the father) who works for the Ministry of Magic in the Misuse of Muggle Artifacts Office has secured top notch tickets for all to attend the World Quidditch Cup. This fantastic event is marred by the appearance of signs of support for Voldemort by his followers, the Death Eaters, and Arthur hurries home with his charges in tow via Portkey transit.
Harry, now fourteen, enters Hogwarts for his fourth year. This year is different for all of the students due to the resurrection of the Triwizard Tournament, a dangerous international competition for a selected champion from each of three schools, Durmstrang, Beauxbatons, and Hogwarts. Although underage, Harry is selected by the Goblet as an extra competitor from Hogwarts. Everyone is concerned for the competitors' safety (the famous Viktor Krum, the enticing Fleur Delacour, and the decent Cedric Diggory). In particular, Harry's life is in danger from suspected foul play.
Adolescent love, the nastiness of poison-pen reporter Rita Skeeter, the ever-vigilant nature of Mad-Eye Moody (an Auror who caught Death Eaters in the past and who now teaches Defense Against the Dark Arts), spells that cause loss of control, excruciating pain or death, enslavement of house-elves, money, and variable degrees of professionalism by members of the Ministry of Magic, such as Cornelius Fudge, Bartemius Crouch, officious Percy Weasley, and Ludo Bagman are some of the themes and subplots in the novel. The traumatic end to the competition and follow-up lead Harry to witness and participate in some horrific events. Dumbledore, however, refuses to allow Harry to bottle-up the experience--Dumbledore understands that talk, openness, support, and rest are the first steps towards healing.
Written by surgeon and renowned author Sherwin B. Nuland, this book offers both a detailed look into the workings of the human body and a glimpse into the heart and work of the author. Furthermore, it is also a philosophical treatise on the wonder of human life and the beauty of "animal economy." As a human biology text for the layman, the book explicates the major organ systems of the human body, such as the nervous system (including the sympathetic nervous system), the cardiovascular system, the gastrointestinal tract, the immunologic and hematologic systems (including coagulation, cell lines, lymphatics), and the urogenital system (including reproduction and childbirth).
Nuland intertwines dramatic stories of his surgical patients with the systems review. For instance, the book begins with the near death of a woman by hemorrhage from a ruptured splenic artery aneurysm. Another dramatic story involves the near death of a young diabetic woman from bacterial overgrowth in the gut. The reader also hears the patients' versions of their illness experiences--Nuland gives direct quotes from what they have said or written about their experiences. Through it all, Nuland expresses his awe and wonder at the workings and capabilities of the human body.