Showing 351 - 360 of 912 annotations tagged with the keyword "Patient Experience"

The Clinic

MacLaverty, Bernard

Last Updated: Jul-27-2008
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

An overweight, older man is referred by his family doctor to a hospital-based Diabetic Clinic. The patient may have "borderline" diabetes and requires a glucose tolerance test to confirm the diagnosis. He remembers to bring two important items to his appointment - an early morning sample of his urine and something to read. He chooses a volume of short stories by Anton Chekhov.

At the clinic, three things vie for the man's attention: the environment of the waiting room, the requirement of providing a sample of blood and urine every thirty minutes, and one of Chekhov's stories titled "The Beauties." As the patient reads the short story, the clinic surroundings fade away. The existing reality is temporarily doused.

After the testing is completed, he meets with the doctor. Their encounter is brief. The diagnosis is not diabetes but rather impaired glucose tolerance (a condition that might progress to diabetes). The doctor recommends a healthier diet and extra exercise. The man telephones his worried wife with the news that he is alright. Like Chekhov, the patient also understands and savors the drama that is present in ordinary life.

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Summary:

A Place Called Canterbury by social historian Dudley Clendinen, former New York Times national correspondent and editorial writer, provides readers with an intimate and revealing account of aging in a particular place at a particular time--Canterbury Tower in Tampa, Florida. The story about the author's mother, Bobbie--and so many others--begins in 1994, a few years after the death of James Clendinen, Bobbie's husband of 48 years, and known to the community as the progressive editor of the Tampa Tribune. Although she had been "falling apart, a piece here, a piece there...collapsing vertebrae...bent, frail, and crooked...subject to spells and little strokes...." (p. xii),

Bobbie Clendinen was in reasonably good health. Nevertheless, her grown son and daughter did what most children their age do--they worried. When she finally agreed to move from the home where she had lived for twenty-nine years to Canterbury Towers, room 502, two bedrooms, two baths ($88,000 in cash, $1505 each month), Clendinen and his sister were relieved. She would be cared for and safe in "the small, cream colored, obsessively well-run geriatric apartment tower and nursing wing...across a broad boulevard from an arm of Tampa Bay" (see book cover).  And, so many of her old friends were already established residents!

Clendinen was fascinated by his mother's new circumstance and by what he came to regard as the new old age. As a writer, he could not resist the opportunity before him. Although he lived in Baltimore, he could come and go, but over the twelve-year period of his mother's residence--three in the Towers and nine years in the hospital wing--he spent more than 400 days as a live-in visitor, observer, listener, interpreter. This unusual arrangement provided Clendinen with a close-up view of a 21st Century phenomenon, the comings and goings of aging people in the final setting of their lives.

Canterbury is a well-run camp and life there is a soap opera. Between his exchanges with the witty rabbi and the former jitterbug champs, the enthusiasm generated by a nudity calendar proposal (declined) and the geriatric bib enterprise (thriving), the inhabitants provided Clendinen with an abundance of riches. Whether at lunch in the dining room overlooking the Bay, over daily drinks at 5pm, or in bed in the health center, everyone of this Greatest Generation had a story to tell. This ethnographic page-turner, with its cohort of named characters--the Southern Belle, the Rabbi who escaped the Holocaust, Emyfish, the ageless New Yorker, Lucile, the warm-hearted Fundamentalist, the raunchy Atheist, the crusty Yankee, the horny widower, and the maddeningly muddled Wilber--reads like fiction. Whether rich or poor, married or widowed, Clendinen listened as they spoke and in doing so became a trusted friend and chronicler of small and great events in their collective lives: childhood, Depression, World War II, medical advancements, healthcare costs, 9/11. Because Bobbie Clendinen spent so many years in the hospital wing, much of the story describes the kind of care and staff standards that we would hope for all--including ourselves. Mrs. Clendinen died at age 91.

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A Spot of Bother

Haddon, Mark

Last Updated: Jun-12-2008
Annotated by:
Belling, Catherine

Primary Category: Literature / Fiction

Genre: Novel

Summary:

George Hall has recently retired when he discovers a lesion on his hip which he takes to be skin cancer. Even though his doctor tells him that it is simply eczema, George is not reassured for long. His worry gradually becomes panic. He learns that his wife, Jean, is having an affair with an old friend of his, that his daughter, divorced single mother Katie, is going to marry a man he disapproves of, and that his son, Jamie, intends to bring his gay lover to the wedding. At this point his hypochondria becomes distinctly pathological. He attempts to excise the lesion himself with kitchen scissors and ends up in hospital.

With the help of antidepressants and psychotherapy, he begins to recover, and then, finding other marks on his skin, relapses. Things come to a climax at Katie's chaotic and (for the reader) very funny wedding, where George, on a risky mixture of valium and alcohol, makes an overly confessional speech and then physically attacks his wife's lover. Order is restored with the help of Jamie and Ray, the groom, who turns out to be heroically kind and efficient (and whose working-class status is then forgiven by George and Jean), and the novel ends with happy reconcilations. George's health anxiety has not, though, entirely disappeared and the novel ends with a clear sense of the mental effort required, especially as we age, not to give in to our fears of disease and death.

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Before the Shot

Rockwell, Norman

Last Updated: Jun-01-2008
Annotated by:
Mathiasen, Helle

Primary Category: Visual Arts / Painting/Drawing

Genre: Oil on canvas

Summary:

As a father of three boys and a friend of the famous doctors Erik Erickson and Robert Coles, Rockwell had plenty of opportunity to study doctors interacting with patients. Before the Shot is one of his humorous doctor-patient scenes. Published as a Saturday Evening Post cover, March 15, 1958, this oil painting depicts a doctor's examination room with the male physician and his young male patient standing with their backs to each other. In the foreground the young boy stands on a chair in his undershirt. He grasps his belt and pants around his buttocks and leans forward toward the wall, his nose up against one of his doctor's framed diplomas. On the chair are his coat, hat, and scarf. His heavy shoes are on the floor. The doctor stands behind him facing the window and holds a syringe in his hand. The walls of his office are hospital green; the floor grey and white linoleum tile. The dominant color is green. It is daytime.

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Summary:

This is a collection of approximately 45 pathographies-essays, memoirs, biography, autobiography, poems, and reflections on illness experiences -grouped loosely into four categories of related subject matter. These categories are: Illness and Identity: Dynamics of Self and Family; Concealing Illness, Performing Health; Agency and Advocacy; Medicine at the Margins. The majority of the pieces are written by non-health care academics about their experiences with a wide variety of illnesses. A few have been written by or with health care professionals.

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Summary:

Body of Work is a cleverly crafted memoir - or, rather, the first chapter of a memoir - of the author's medical school experience at Brown University School of Medicine in Providence, Rhode Island. Ms Montross relates the chronological course of her team's dissection of a female cadaver with no discernible umbilicus and whom they therefore name Eve. (She neglects to comment on Eve's ribs and whether she has the normal complement or a supernumerary, more masculine, rib.) As she and her team of four (later three as one student drops out of school) proceed with the orderly dismantling of Eve, bone by bone, nerve by nerve and blood vessel by blood vessel, she uses this experience as a springboard to analyze her and her team's emotional reactions to the often unnatural process of deconstructing, literally (at times with a saw), a former person now cadaver, as well as the gradual, almost imperceptible acculturation that transmogrifies medical students into doctors. In fact, she devotes the final pages to this metamorphosis and what it means to the person undergoing the transition from caring student to detached physician, and whether one can retain enough caring, while remaining sufficiently detached to function as one must as a clinician, to become both a whole person and competent physician: "How much of becoming a doctor demands releasing the well-known and well-loved parts of my self?" (page 209)

Although it primarily revolves about the axis of her gross anatomy (cadaver dissection) course, the author's narrative includes tangents that have variably relevant relationships to this course, e.g., a trip to Italy to inspect first hand the anatomy theater of Vesalius in Padua and the Basilica of St. Anthony; another trip to the anatomical wax sculptures museum in Bologna, where the author also observes the "incorrupt corpse of Santa Caterina" in a "small church called Corpus Domini" (pages 223-224); interspersed histories of the traffic of corpses for dissection, including the infamous Burke and Hare story; some flash-forwards to her second and third years; and a prolonged narration of the final illnesses of her grandmother and grandfather. This last bit of family history is worth the price of the book alone. Despite the apparently incongruous collection of such asides, the author makes it work smoothly, if not seamlessly.

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A Step From Death

Woiwode, Larry

Last Updated: Apr-25-2008
Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

In A Step from Death a profusion of memories radiate from a near-fatal accident on Larry Woiwoide's farm in western North Dakota. Woiwode, a novelist and poet of America's heartland, had just finished baling hay when his denim jacket got caught in the tractor's power take-off, "a geared stub at the rear of the tractor that spins at 500 rpm." (p. 9) Caught in the powerful machine with no one around to hear his cries for help, Woiwode could easily have died, but survived by using his pocket knife to free himself from the jacket.

In a sense A Step from Death takes up where the author's previous memoir, What I Think I Did, leaves off. The earlier book focuses on surviving North Dakota's outrageously bitter winter of 1996-97. The current memoir ranges far and wide over nearly 40 years of Woiwode's life as a writer who chooses a difficult but fulfilling life for himself and his family on the land. The memoir is addressed to Woiwode's only son Joseph (the second of four children), with whom he shares his fatherly failures, as well as the strengths of their relationship. The reader soon learns that accidents were no strangers to their life on the northern plains. Woiwode and his wife and older daughter had survived a serious car accident on an icy road in one of their early Dakota winters. Joseph, too, sustained severe injuries as a child when he fell off a horse and again later in a tractor accident. On another occasion, Joseph and his sisters are responsible for accidentally causing a fire that burned down the family barn.

Now, however, Joseph is a married man, a helicopter pilot, with two children of his own. The recollections and wisdom that his father shares with him (and us) flow freely, creating a free associational, rather than linear, narrative. Woiwode explores the deep network of connections that bind him to the land and his family, as well as to the community of creative writers and especially William Maxwell, his long-time editor at The New Yorker, mentor, and father figure. Woiwode explores as well the strong pull of loss in his life-his parents' deaths and eventually that of Maxwell-but A Step from Death is ultimately a celebration of survival.

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Second Opinion

Kendrick, Leatha

Last Updated: Apr-19-2008
Annotated by:
Davis, Cortney

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

Poet Leatha Kendrick is the author of two chapbooks, Science in Your Own Back Yard (see annotation) and Heart Cake. In this full-length collection she continues to examine themes explored in her first titles: love and loss; the fleeting of time; and her personal experience of breast cancer. Second Opinion is divided into three sections: the first two sections have 14 poems each, the final section has 13, perhaps to indicate that for this passionate and articulate poet the the final poem is yet to be written. The first poem in the collection, "A lesson in Love Unleashed," sets the theme for the poems that follow: "yes, I think, even in their distorted flesh, / I still desire what's gone. What I'm leaving" (p. 3). In the first and third sections, the poet writes of marital and familial trials and triumphs, both past and present, and in the second section--for me the most vivid in the collection--she writes about breast cancer and how this experience weaves in and out of her other loves and losses. This weaving is given both visual and emotional expression in the poem "Tonight Weaving" (p. 28)

Throughout the book, Kendrick's poems take varying forms and tones, and yet there is always the assurance of a constant voice--personal, passionate and often humorous. In the second section, the poems become more visually complex and fractured, poetic representation of the "distortion" of the flesh as the narrator considers the diagnosis and treatment of her breast cancer. In this section's opening poem, "The Calculus of a Cracked Cup," the poet writes, "Our position is never certain, only our / velocity" (p. 27), adding the concern of the swift passing of time to the collection's overall theme. In "Second Opinion," the title poem, she notes, "I want to believe in sudden remission, / in some way to avert what we are certainly / headed for" (p. 34). But while time rushes on, the reality of cancer, the loss of a breast becomes a "stopped surface" under which a "lost life" wants "its old course, not subject to IVs or a knife" (p. 35).

It is life--difficult and sweet--that is ultimately celebrated in these poems and that overcomes the losses. The most wry poems are found in the breast cancer section: "Christmas, Adolescence, Yin and Yang" (p. 32) is a sort of ode to "Skeeter and Bite," so named by a first love; now "they'll lift / one out, the eye sewn shut by mastectomy." "Costume. Fakery. The Sell." is a tough, nervy poem that has the narrator claiming acceptance for who she is, post surgery: "Alive! Tender, I'm not hiding" (p. 39). Throughout the book there is a subtle triple play on the word "tender": woman as caregiver; woman as collateral in a society that values cleavage; and woman as injured, post op, and physically vulnerable.

In the collection's final poem, "What You Leave Me," the theme of love and loss balanced against time comes to some resolution as the narrator and her partner join in a "sweet tangle": "the blossoming / hide, this bounded / time against brevity" (p. 64).

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Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Poems (Sequence)

Summary:

This book consists of a series of "found poems" abstracted from transcripts of interviews that Loreen Herwaldt conducted with 24 writers who had previously published accounts of their illnesses. Dr. Herwaldt, an infectious disease specialist at the University of Iowa, began her investigation into the personal experience of illness after having read Mary Swander's Out of this World: A Journey of Healing and Reynolds Price's A Whole New Life, both of which revealed a negative dimension of medical care. These books initiated an "unexpected turn" (p. 1) in Dr. Herwaldt's life, culminating in a sabbatical year during which she interviewed a wide array of writers, intending to investigate the texture and dynamics of their experience of medical care by textual analysis of interview transcripts.

However, as a result of a further (and fortunate) insight, the author decided to abstract and arrange these texts into "found poems" that have "a concentrated emotional power that the unedited stories did not." (p. 5) Among the authors whose stories of illness appear in these poems are Arthur Frank (see The Wounded Storyteller ), Nancy Mairs (A Troubled Guest: Life and Death Stories), Richard Selzer (Raising the Dead), Oliver Sacks (A Leg to Stand On), Mary Swandler (The Desert Pilgrim: En Route to Mysticism and Miracles), and Christina Middlebrook (Seeing the Crab: A Memoir of Dying). In most cases Dr. Herwaldt has crafted two or more poems giving voice to different aspects of the subject's experience. For example, Richard McCann (pp. 82-90) speaks about loving his primary care physician, why patients can't talk to doctors, what he needs from a doctor, and being labeled as a patient with hepatitis C (cf. "The Resurrectionist").

The author includes a section on "How to Use This Book" (pp.9-20) that summarizes her experience utilizing these poems in medical education settings and provides helpful hints for teaching them.

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Cancer Vixen

Marchetto, Marisa

Last Updated: Apr-03-2008
Annotated by:
Holmes, Martha Stoddard

Primary Category: Literature / Nonfiction

Genre: Graphic Memoir

Summary:

Cancer Vixen is the graphic narrative of Marisa Acocella Marchetto’s eleven-month cancer experience in 2004. Marchetto, a successful forty-something cartoonist for Glamour magazine and the New Yorker, serialized Cancer Vixen in Glamour while undergoing treatment. As well as the narrative of Marchetto’s diagnosis, treatment, and remission, Cancer Vixen recounts the story of Marchetto’s romance and engagement to restaurateur Silvano Marchetto, a narrative embedded in the graphic novel despite preceding it in actual chronology. The narrative explores fears about the cancer's effect on the relationship and about the loss of the chance to be a biological mother, as well as developing the relationship between the engaged couple and between Marisa and her mother (or "(s)mother," as she calls her).

The culture of cancer is another focus, including the social dynamics of having hair during cancer treatment and thus leaving oneself open to critique for not undertaking a strong enough chemotherapy. While this New York story, full of cuisine, couture (including images of the specific shoes Marchetto wore to each chemo), and cappuccino may recall the episodes of the television show Sex in the City featuring cancer, the brightly colored frames of this “Cancer in the City” tale also engage political issues like environmental causes of cancer and the reduced survival rates of women with cancer and no insurance.

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