Showing 331 - 340 of 470 annotations tagged with the keyword "Medical Ethics"

The Case of Dr. Sachs

Winckler, Martin

Last Updated: Nov-27-2002
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Novel

Summary:

At the heart of this novel is a simple love story. Dr. Bruno Sachs, a slight, stooped, and somewhat unkempt general practitioner in a French village is dedicated to his work and loved by his patients. Sachs is a solitary, self-effacing man who takes his Hippocratic duties seriously and is especially sensitive to the needs of his patients.

In addition to his private practice, Sachs works part-time at an abortion clinic, where he performs an abortion on a distraught young woman named Pauline Kasser. Soon the doctor and his patient fall in love. She moves in with him and becomes pregnant. An editor by profession, Pauline also encourages and assists Dr. Sachs in completing the book he is writing.

The story has many additional layers and dimensions. The reader views Sachs through the eyes of multiple narrators--his patients, colleagues, friends and acquaintances, all of whom write in the first person and present Bruno Sachs as "you" or "he." Thus, the reader gradually builds up a "connection" (empathy) with Sachs by synthesizing multiple glimpses of his behavior and facets of his character. At the same time, Sachs is trying to find his own voice, his own connection, by becoming a writer. At first he jots down random thoughts, then he keeps a notebook, and eventually he produces a complete manuscript.

The book has innovative structural elements that introduce other layers of meaning. For example, the 112 short chapters are organized into seven sections, corresponding with the components of a complete clinical case history: presentation (as in "chief complaint"), history, clinical examination, further investigations, diagnosis, treatment, and prognosis. Similarly, the narratives delve progressively into Sachs' "illness" and follow the "patient" through his course of "treatment."

Another structural element is the cycle of fertility and gestation. The story takes place from September through June, precisely 40 weeks, a pregnancy of nine months, during which Sachs is re-born.

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Annotated by:
Kohn, Martin

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Set in post- World War II Vienna, this movie is "a portrait of postwar corruption and the death of idealism" (Michael Wilmington, in the DVD insert). Holly Martins (Joseph Cotton) comes to Vienna at the request of his old friend Harry Lime (Orson Welles). He arrives to find that Harry has been killed in a questionable automobile accident. A police inspector (Trevor Howard) informs Holly that his friend Harry had been involved in racketeering and maybe deserved to die.

Trying to clear the name of his friend, Holly discovers the depth of his friend's evilness--Harry was not a petty thief; he was involved in stealing penicillin from military bases and then selling diluted (and thus ineffective) doses to hospitals. The police inspector convinces Holly to turn on his friend (Harry was not the victim of the automobile accident--another of his cruel deeds!) who is finally killed by Holly in the sewers of Vienna. Of course there is Harry's girlfriend (Alida Valli) who rebuffs Holly and remains true till the end to Harry.

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Summary:

This collection is a wide-ranging view of physician poets writing not only about their professional roles, but about themselves and those around them as human beings. The anthology came about as a tribute to one of its major contributors, poet-physician Rita Iovino who spent many years of her life working with other physician writers and their creative natures.

All of the 29 contributors are physicians and the range of subject matter is broad. The collection is divided into subject matter clusters: Of Medical Matters; Of Love Matters; Of Family Matters; Of Natural Matters; Of Life and Death Matters; Of Philosophical Matters; Of Holy Matters; and two prose essays on the role of poetry in the lives of physicians.

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Year of Wonders

Brooks, Geraldine

Last Updated: Aug-20-2002
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

The narrator of this historical novel, Anna Frith, works as a servant in the household of the local minister. The story recounts the horrific events in a plague-ridden village of 17th-century England. Anna, having lost her young husband in a mining accident, loses both her sons to the plague, as well as a boarder in her household who seems to have been the first case in the village.

After these losses, she stays her grief by tending the sick in many families. Particularly after the village works out terms of quarantine with the earl, no help but food and supplies comes in from outside. She learns much from the local herbalists, two midwives whose work she carries on after their violent deaths. In this work she develops a close partnership with the pastor's wife.

The story takes us through the whole trajectory of loss, accusations, spiritual struggle, shared grief, creative adaptations, and eventually emergence from sickness and quarantine. Anna's own journey takes some surprising turns as her confidence and clarity about her own mission grow and deepen.

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The Plague

Camus, Albert

Last Updated: May-03-2002
Annotated by:
Marta, Jan

Primary Category: Literature / Fiction

Genre: Novel

Summary:

One April morning in the 1940's in Oran, Algeria, Dr. Rieux, preoccupied with his ill wife's imminent departure to a sanatorium, discovers a dead rat. This unusual event marks the beginning of an epidemic of bubonic plague that will besiege the city until the following February. Over the long ten months Rieux, his acquaintances, friends, colleagues and fellow citizens labor, each in his own way, with the individual and social transformations caused by the all-consuming illness. Separation, isolation, and penury become the common lot of distinct characters whose actions, thoughts and feelings constitute a dynamic tableau of man imprisoned.

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Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Novel

Summary:

To relieve her insomnia, Claire Vornoff seeks help from Dr. Declan Farrell, a well-known holistic physician, who begins to see her professionally at his country home. Farrell's methods focus on massage and bodywork, along with some acupuncture. Claire finds him an attractive paradox--sensitive and "tuned in" to her, yet also blunt and emotionally unsettling.

The client-therapist relationship becomes deeper and more complex. After Claire has a brief sexual escapade with a married man, she admits to herself that she actually loves Declan and confesses her love to him. Indirectly, he reveals that he also has strong feelings for her, but is desperately resisting those feelings and attempting to maintain his professionalism.

Claire finally breaks off their relationship and attempts to go on with her life. Over the next couple of years, Declan closes his practice, moves elsewhere, divorces his wife, and ultimately commits suicide. Claire learns of these events gradually, at second hand, as she, too, moves on, but in much a different direction. Eventually she begins a new life in Toronto.

Although the relationship between Claire and Declan occupies center stage, Claire's quest for improved health leads her to consider, and sometimes consult with, other alternative medicine practitioners as well. (I say "improved health" rather than "relief of insomnia" because, although never stated, it seems clear that Claire seeks a sense of completeness and meaning in life that goes far beyond solving her sleep problem.)

One of these healers, for example, is Mr. Spaulding, who reviews Claire's blood work and concludes, "You're in rough shape, girl." (p. 231) He explains that her "body salts are so high I can't measure them" and that her "body is throwing off one hundred times more dead cells than it should . . . "

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The Doctor Stories

Selzer, Richard

Last Updated: Apr-09-2002
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Collection (Short Stories)

Summary:

In this collection Richard Selzer brings together 25 stories from his previous books, along with two new stories, Avalanche (see this database) and "Angel, Tuning a Lute." The unifying theme is the world of medicine and healing, which Selzer explores with a keen eye and compassionate heart. These stories are firmly grounded in the foibles, suffering, and exultation of the human body.

In the Introduction Selzer sketches the path by which he became a surgeon-writer and he indicates the origin of some of the stories. Particularly interesting are the stories that do homage to literary and historical figures; for example, "Poe's Light-house," which grew out of a fragment Edgar Allan Poe wrote in his last delirium, and "The Black Swan," a re-writing of a Thomas Mann novella (Mann's The Black Swan is annotated in this database).

Likewise, the story of how "Avalanche" was written is an interesting tale in itself. Selzer's description of pruning the story from his journal reminds me of Michelangelo's comment that the sculpture already exists in the block of marble. The sculptor merely removes the unnecessary stone. The Doctor Stories contains many of Selzer's tales that have become part of the Literature and Medicine canon; these include, for example, "Tube Feeding," "Sarcophagus," Imelda, Mercy, Brute, and Four Appointments with the Discus Thrower. (See this database for annotations of the latter four.)

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Black Dogs

McEwan, Ian

Last Updated: Apr-09-2002
Annotated by:
Belling, Catherine

Primary Category: Literature / Fiction

Genre: Novel

Summary:

The narrator, Jeremy, orphaned at age 8, is attempting to write a memoir of his wife's parents, June and Bernard Tremaine. The pair married in England in 1946, idealistic young members of the British Communist Party, but on their honeymoon in France something happens to June that estranges her from her husband and his values forever. After the birth of their daughter, Jeremy's wife, the two live separately. June dies in a nursing home in 1987, after telling Jeremy a great deal about her life and marriage.

In 1989 Jeremy and Bernard travel to Germany together to share in the dismantling of the Berlin Wall. Bernard has taken a lot longer than his wife did to give up on communism. In Berlin, Jeremy hears his father-in-law's very different version of the couple's biography. Jeremy then travels to France to try and unearth the truth about their honeymoon, finding unreliable storytellers, poor memory, and, at the center, June's encounter in the French countryside with a pair of black dogs, owned and trained and then abandoned by the Gestapo. The story, as Jeremy reconstitutes it, is a discovery of evil that, regardless of literal factuality, bears a terrible truth about the human capacity to do harm, both personal and political.

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Amsterdam

McEwan, Ian

Last Updated: Apr-09-2002
Annotated by:
Belling, Catherine

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Molly Lane, restaurant critic and photographer, has died of a progressive neurological disease. She is survived by George, her husband, as well as by several past lovers, including Clive Linley, a famous composer, his old friend Vernon Halliday, editor of a London newspaper, and Julian Garmony, the British foreign secretary, rumored to be headed for Downing Street. After Molly's funeral, both Clive and Vernon experience odd neurological symptoms and make a mutual pact to help each other commit suicide in order to end suffering. The symptoms appear in both cases to have been psychosomatic, but the pact remains.

George has found career-destroying photographs of Julian Garmony (in drag) among Molly's things, and he gives them to Vernon for the newspaper. Vernon and Clive quarrel over the ethics of a decision each has made: Vernon's decision to publish the pictures, and over Clive's decision not to intervene when, while working on a crucial melody for his symphony during a walk in the country, he sees a woman being attacked by a man who turns out to be a serial rapist. When Vernon is fired and Clive's symphony is a failure, each blames the other and the suicide pact becomes a means of mutual revenge.

A subtext has been a running storyline in Vernon's paper about rumored abuse of the Netherlands's liberal euthanasia laws; the novel ends in Amsterdam, each man involuntarily euthanized by a physician paid by his friend. (Meantime, Garmony's career is in ruins. George has successfully destroyed all three of his wife's lovers.)

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Annotated by:
Duffin, Jacalyn

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Dr. Constance Petersen (Ingrid Bergman) is a beautiful, unattached psychiatrist whose business-like facade fails to conceal a natural empathy that draws men. For her, however, love is a mere epi-phenomenon, easy to explain and resist, until she meets Dr. Edwardes (Gregory Peck). The famous expert on the guilt complex has arrived to replace the retiring chief (Leo Carroll). Constance is smitten, and so, it seems, is he.

But soon, she realizes that Edwardes is "not well," that he is terrified of dark lines on white: fork marks on a tablecloth; threads in her robe. Worse, she discovers that Edwardes is not, in fact, Edwardes, but an amnesic physician of initials "J. B." who is convinced that he has murdered his analyst. Constance does the right thing by having him removed from work, but she refuses to believe he is a murderer. Wanting to protect her, he leaves. But she, intent on curing her lover, follows him on a journey to retrace his last movements. The task is to recover both a memory and a missing person.

They go skiing (dark lines on white) at a resort where the real Dr. Edwardes had sojourned with his patient-colleague. On a dangerous slope, J. B. suddenly remembers that Edwardes went over the cliff. The body is found, but it has a bullet in the back.

Now hiding from the police, the couple pose as newlyweds and flee to her old mentor in Rochester. Complete with accent and beard, Dr. Brulov (Michael Chekhov) is a delightful double of the recently deceased Sigmund Freud (1858-1939). It emerges that John Ballantine (Peck) never lost his childhood feelings of guilt over the accidental death of his little brother.

In a gruesome ten-second flashback, the tyke is abruptly impaled on a iron-spike fence. This ancient guilt was reactivated by his doctor’s demise and it was sublimated by the defense mechanism of an assumed identity to keep the dead man alive. An idle slip of the tongue reveals the murderer to be the jealous retiree. The killer threatens Constance and then makes a quick end by dispatching himself instead.

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