Showing 331 - 340 of 473 annotations tagged with the keyword "Medical Ethics"

Heart of the Land

Gray, Andrew

Last Updated: Jan-28-2003
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

A lonely neurosurgical resident becomes involved with a comatose patient. Susan, a dying woman with an inoperable brain tumor, is the subject of a research study. Scientists are attempting to discern her thoughts with the aid of computers. The resident serendipitously stumbles onto a program that successfully translates the electrical activity of Susan's brain into speech. He labels the computer program a failure (but saves a copy for himself) so that others are unable to eavesdrop on her dreams.

He spends nights listening to her thoughts and soon begins communicating with Susan, sharing his own secrets with her. When the resident learns that the research project is about to be terminated, he decides that Susan is in desperate need of human contact. He kisses her and presumably has sexual intercourse with the comatose woman. The next morning he is found asleep beside her and is dismissed from the hospital.

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Progressive Health

Dennis, Carl

Last Updated: Jan-22-2003
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Poem

Summary:

A corporate narrator ("We here at Progressive Health") thanks the poem's addressee (presumably the poet) for "being one of the generous few who've promised / To bequeath your vital organs to whoever needs them." However, the narrator goes on to point out that there is another, even more generous, step he could take, by "acting a little sooner than you expected." In fact, why not turn tomorrow morning's routine physical examination, which wouldn't ordinarily benefit anyone except the poet himself, into a splendid opportunity to save six lives?

Yes, indeed, at this very moment there are six persons whose lives are hanging by a thread in the ICU, and the poet is a good tissue match for every one of them. If he would agree to have his liver, spleen, lungs and kidneys removed, and transplanted into these patients, he would save six lives.

Of course, the poet would die, but look at the situation from a cost-benefit analysis: The poet, who is "an aging bachelor," has perhaps 20 more years of life left in him and the poems he might yet write--even assuming they are better than those he has thus far written--are not going to "raise one Lazarus from a grave / Metaphoric or literal." On the other hand, the six potential beneficiaries have a multiplier effect because of their husbands and wives, parents and children.

The great gratitude of so many people will mean that the poet will be remembered after death--"Summer and winter they'll visit your grave, in shifts, / For as long as they live, and stoop to tend it, / And leave it adorned with flowers . . ."

Alternatively, if he chooses selfishly to refuse, and to grow old and die, his friends will likely forget him after death; and, moreover, his conscience will probably be stricken by having failed to respond to these patients' needs. The poem concludes, "You could be a god, one of the few gods / Who, when called on, really listens?" [48 lines]

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Life Support

Gerritsen, Tess

Last Updated: Jan-13-2003
Annotated by:
Kohn, Martin

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Set in contemporary Boston, this medical thriller not only gets the reader's blood moving, but also raises some important ethical questions: How do corporate interests influence the judgment and character of physician researchers? To what length should older persons go to slow down the aging process? How does one's lifework of health care fit in with obligations to one's family?

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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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