Showing 341 - 350 of 476 annotations tagged with the keyword "Medical Ethics"
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.
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 . . . "
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.)
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.
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.)
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.
The narrator, Latimer, begins the story with a vision of his death, which he attributes to a heart attack. He explains that, always sensitive after a childhood eye affliction and his mother's death, the further shock of a "severe illness" while at school in Geneva enabled him to see the future, and to hear others' thoughts--an experience which he describes as oppressive. He is fascinated by his brother's fiancée, Bertha, the only human whose thoughts are hidden from him, and whom he marries after his brother dies in a fall.
The marriage falters after Latimer eventually discerns Bertha's cold and manipulative nature through a temporary increase in his telepathy. When Latimer's childhood friend, the scientist Charles Meunier, performs an experimental transfusion between himself and Bertha's just-dead maid, the maid briefly revives and accuses Bertha of plotting to poison Latimer. Bertha moves out, and Latimer dies as foretold.
In the "free love" context of the nineteen-sixties, Harriet and David Lovatt are throwbacks to a more conservative, traditional, and family-oriented decade. Their life dream is to have a big house in the country filled with children, and it seems that they will succeed. After bearing four young children, however, Harriet is feeling the strain of years of childbearing, sleeplessness, money trouble, and her parents' and in-laws' disapproval of her fecundity.
Her fifth pregnancy is not only unplanned, but also unusually painful and disruptive. Harriet's doctor prescribes sedatives but finds nothing abnormal in her situation. When Ben is born, Harriet jokes that he is like "a troll or a goblin," but no one responds well to this unusually hairy and physically vigorous baby, who in turn does not respond to anything but his own desires and fears.
As he grows older, family pets and other children seem to be in physical danger. Health care professionals do not confirm the couple's conviction that Ben is not normal, but neither do they obstruct the decision to send Ben to a private institution, a removal that leaves the family temporarily happy until Harriet visits Ben and recognizes the institution for what it is, a place where all manner of "different" children are sent to live heavily medicated, physically restrained, and foreshortened lives away from families who do not want them.
Harriet brings Ben home, where he grows up amid what remains of the Lovatts' domestic fantasy, and finds community in a gang of thuggish older boys whom Harriet suspects are involved in various criminal acts. As the story closes, Ben has left home and Harriet imagines him in another country, "searching the faces in the crowd for another of his own kind" (133).
Summary:Hilfiker describes a number of his own medical errors. He is concerned with the physical, emotional, social, and economic consequences of medical mistakes, all of which have grown as medicine's ability to cure disease has grown. Hilfiker contends that physicians are poorly equipped to cope with their own mistakes. The nature and practice of medicine are such that it is often possible to conceal mistakes from patients. Should they be concealed? Hilfiker says not. He implies that there are few (if any) circumstances which warrant deception.
In "Fortitude" Dr. Elbert Little, a Vermont family physician, visits the laboratory of Dr. Frankenstein and his trusty assistant, Dr. Tom Swift. Frankenstein has only one patient, Sylvia Lovejoy. His life work has been to keep Lovejoy alive. In 78 operations over the last 36 years, Frankenstein has replaced every one of her organs with prosthetic devices, so that now she consists of a head on a tripod, attached by tubes to various machines.
Frankenstein controls her mood, as he controls all her functions, from a "fantastically complicated" master console. Usually he makes sure that she feels joyful and loving, but last month a transistor went bad in one of the machines and she felt depressed for a while; so depressed, in fact, that she wrote to Dr. Little and asked him to bring her some cyanide.
Lovejoy's only friend is Gloria, the beautician who comes every day to care for her hair. Gloria is horrified over what Sylvia Lovejoy has become; she sees only a "spark" of the real person remaining, but she knows that the "spark" wants to die. After Frankenstein fires Gloria for speaking about death in Sylvia's presence, she sneaks back into the room when Sylvia is sleeping and puts a loaded revolver in her knitting bag.
Later, Sylvia finds the gun and tries to kill herself, but her prosthetic arms have been designed not to allow her to do that. Instead, she shoots Frankenstein, who promptly becomes the second head attached to the machines. (It seems he has designed all the prosthetic organs to be able to serve two "persons," so that he and Sylvia will be able to "live in such perfect harmony . . . that the gods themselves will tear out their hair in envy!")