Showing 331 - 340 of 431 annotations tagged with the keyword "Professionalism"

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."

View full annotation

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).

View full annotation

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.

View full annotation

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).

View full annotation

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."

View full annotation

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.

View full annotation

Annotated by:
Kennedy, Meegan

Primary Category: Literature / Fiction

Genre: Collection (Short Stories)

Summary:

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").

View full annotation

Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

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).

View full annotation

Summary:

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.

View full annotation

Lives of Moral Leadership

Coles, Robert

Last Updated: Mar-20-2001
Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

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.

View full annotation