Showing 361 - 370 of 486 annotations tagged with the keyword "Art of Medicine"

The Nose

Gogol, Nikolai

Last Updated: Feb-07-2002
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Collegiate Assessor Kovalyov wakes up one morning and discovers that his nose is missing. At the same time in another part of St. Petersburg, Kovalyov's barber finds the nose in his breakfast roll. However, the barber, desiring to disassociate himself from the strange incident, proceeds to toss the nose into the Neva River. A little later, Kovalyov happens to see his nose riding in an elegant carriage and wearing the uniform of a State Councillor (a higher rank than Collegiate Assessor). He demands that the nose give itself up, but is rudely rebuffed.

At first neither the police nor the newspaper offer any help, but later a police officer, who happened to observe the barber throwing an object into the river, returns the lost nose to Kovalyov. However, a new problem arises. How will he re-attach the nose to his face? For this he consults a doctor, who recommends letting nature take its course, "it's best to stay as you are, otherwise you'll only make it worse." Poor nose-less Kovalyov! He becomes the laughing stock of St. Petersburg, until one morning he wakes up and finds his nose re-attached firmly to his face.

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Annotated by:
Sirridge, Marjorie

Primary Category: Literature / Nonfiction

Genre: Autobiography

Summary:

Dr. Sacks was growing up in London during World War II and had a very traumatic experience when he was sent away from his home for protection from the bombing. He and his brother were sent to a boarding school, where they were beaten and underfed. Sack's home had been filled with a wonderful extended family of physicists, mathematicians, teachers, and chemists, in addition to his parents who were both practicing physicians. Being unusually bright and talented, Sacks responded to a wide variety of stimuli when he returned to this environment.

He became fascinated with the chemistry of metals and with the periodic table of elements. An uncle, for whom the book is named, was a manufacturer of light bulbs with tungsten filaments and encouraged him in setting up his own chemistry laboratory in the family laundry room, to do experiments. The family allowed him a great deal of freedom, which encouraged his creativity.

In writing about these experiences Sacks includes the history of the development of chemistry concepts that fascinated him. It was only much later that his interests moved on to the natural sciences and medicine. He says that his parents had been tolerant and even pleased with his early interests in chemistry but by the time he was fourteen they felt that the time for play was over. He kept a journal from the age of fourteen and took advantage of every opportunity to read broadly and experience nature, music and art.

In retrospect, however, Sacks felt that life was shallower after he left behind his passion for chemistry. He says that he dreams of chemistry at night. This description of such intense interest in the world around him and the people he read about or knew explains a great deal about his great success as a neurologist and as a remarkable story teller.

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The Doctor

Fildes, Sir Luke

Last Updated: Feb-05-2002
Annotated by:
Shafer, Audrey

Primary Category: Visual Arts / Painting/Drawing

Genre: Oil on canvas

Summary:

Sir Luke Fildes's eldest son Phillip died Christmas morning, 1877. He was attended by Dr. Murray, who directed all of his attention and care to the patient during the child's fatal illness. This unswerving dedication impressed Fildes.

Ten years later, when Sir Henry Tate commissioned Fildes for a painting to exhibit in what was to become the Tate Gallery, Fildes was given freedom to choose the subject matter. Fildes immediately decided to depict this scene of a family physician holding a bedside vigil by a seriously ill child. However, the painting was not begun for four years, and then only at the urging of Tate.

The shade of a lamp is tilted so as to bestow light on the two central figures: the physician, and especially, the recumbent child. The physician faces away from the bottled medicine and cup on the table and directs his gaze fully on the child. He is dressed neatly and sits calmly, patiently, resting his bearded chin on his hand.

The small child is central in the picture, in a white nightshirt on a large white pillow and covered with pale blankets. The makeshift bed consists of two unmatched dining room-type chairs. The child's hair is tousled and the left arm flung out, with hand supinated and beyond the edge of the pillow. Nonetheless, the child rests quite peacefully, as the pose appears quite natural.

To the right and rear of the painting are the parents. They are placed in such deep shadows that it is frequently difficult to make out these figures in reproductions. The mother sits at a table and hides her face in her clasped hands. The father stands beside her, with a comforting hand on her shoulder, as he gazes at the physician.

The painting is set in the interior of a small cottage. Rafters are low, furniture simple. Colors are muted; earth tones predominate. Although the majority of the light comes from the lamp, a bit of light also enters from the recessed window near the mother.

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Rebecca

Sacks, Oliver

Last Updated: Feb-05-2002
Annotated by:
Woodcock, John

Primary Category: Literature / Nonfiction

Genre: Case Study

Summary:

This is one of the two dozen studies of patients with right-brain disorders that make up Sacks's volume The Man Who Mistook His Wife for a Hat. The nineteen-year-old Rebecca has significant physical and mental defects (her IQ is 60 at best), and by conventional neurological standards she is severely impaired, but Sacks discovers that she has moments of being quite in touch and "together" (her word).

The essay tells of Sacks's discovery of Rebecca's poetic expression and spiritual qualities, and of her self-awareness, in planes unknown to standard neurological and psychiatric categories. Sacks is broadly critical of psychological and neurological testing as constituting a "defectology" that is blind to important human qualities. He warmly recommends music and story-telling, both as modes of understanding and also as narrative therapies that work by ignoring the defects and speaking to the soul.

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Summary:

This is an anthology of poems written by physicians from ancient times through the early part of the 20th century. It includes a great variety of work: poems by well-known physician-writers like Oliver Goldsmith, John Keats, Oliver Wendell Holmes, Sir Arthur Conan Doyle, and William Carlos Williams; poems by distinguished physicians who are not usually remembered as creative writers, such as Edward Jenner, Erasmus Darwin, S. (Silas) Weir Mitchell, and Sir Charles Sherrington; and others by currently little-known physicians.

In the Preface, the editor admits that the genre of "medical poetry" may not have very high standards. For example, she quotes one author as saying that it is generally "poetry in quotation marks and much of it is feeble stuff." However, poetic expression that arises from clinical experience has dignity and value insofar as it reflects "the spirit of helpfulness which gives to the medical profession its value to humanity." The last quotation is attributed by the editor to William Osler, although she cites no reference. Interestingly, the medical professor as reflected in this anthology is entirely male; of 110 poets represented, not one is a woman.

In an "Afterthought" the physician-poet Merrill Moore comments further on the theme of mixing medicine and poetry, presenting the literary equivalent of some insipid "pearls"; for example, "The way he writes is possibly a little different" and "the physician-poet does not quite reach the peaks of spiritual elation and emotional release . . . that a Byron or a Shelley achieves." Profound, huh?

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Summary:

The author provides a historical review of physicians who became famous practicing a profession other than medicine. Most of the article focuses on physician-writers, beginning with Francois Rabelais, and including both well-known and obscure figures. There are extensive comments on Louis-Ferdinand Celine, Gottfried Benn, Friedrich Wolf, Mikhail Bulgakov, Oliver Goldsmith, Anton P. Chekhov, Arthur Schnitzler, W. (William) Somerset Maugham, Sir Arthur Conan Doyle, Oliver Wendell Holmes, William Carlos Williams, among others. The most complete discussion (5 pages) is devoted to Sir Arthur Conan Doyle.

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The Healing Muse

St. Andrews, B. A. (Bonnie)

Last Updated: Dec-19-2001
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

The first poem in this chapbook ("Sonogram") contains two images of a small, mysterious life (the fetus imagined as a "white boat on whiter water" and as a "tiny orca") in the midst of the coldly technical medical world. This juxtaposition is characteristic of B. A. St. Andrews's poems in this small collection. In most of them, she uses disciplined and sparkling language to explore the interface between modern medicine with its impersonal machinery and the irreducible mystery of life.

Some of the images are simply breathtaking. For example, in "A Dying Art: Room 309," a terminally ill artist lies in bed, surrounded by "plastic bags that hang / like udders dripping pigment / into her." In a love poem called "The Body of Science," the poet confesses, "Each time your voluntary / muscles make contact / my involuntary ones / contract." And at the end of "Alzheimer's," she observes, "She stood at the big bay / window screaming but he never / heard what it was she never said."

The four poems entitled "Your Breast a Unicorn" consider the fate of breasts attacked "at consolation's center" by "one aberrant cell metastasized." These learned, wise, and witty poems are, in my opinion, among the very best of the breast cancer genre.

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Summary:

Kirklin, a physician and Lecturer in Medical Humanities at the Royal Free and University College Medical School, and Richardson, a historian and associate at the Wellcome Trust Centre for the History of Medicine, are both educators in medical humanities in London. This well-written and concise volume focuses on "the role of the humanities in medical education" and is aimed at "those wishing to integrate medical humanities into their own teaching, and learning." (p. xv) The chapters are written by a variety of educators with a wide range of backgrounds, including artist, medical student, writer, nurse, surgeon and philosopher.

At least two stimuli are cited as reasons for the development of this book: (1) the 1993 publication by the General Medical Council of Tomorrow's Doctors which recommends the inclusion of medical humanities in the required curriculum for undergraduate medical education in the UK and (2) a national conference, "The healing arts: The role of the humanities in medical education" in London, March, 2000. The rationale for such a book is delineated in several prefatory statements including remarks by Professors Sir David Weatherall and Sir K. George M. M. Alberti (Alberti is the president of the Royal College of Physicians). The book concludes with recommendations for further reading, schemata for undergraduate and graduate degrees in medical humanities at University of Wales, Swansea, and an index.

The nine chapters in this volume combine pedagogic philosophy, citations for literature and art and how to encourage reflection about these selections, tools for encouraging student creativity, reproductions of art and literature generated by students or patients or used by teachers for discussion, and some practical advice about teaching medical humanities and its, at times, uneasy connection to the rest of the curriculum. Each chapter reflects the individual contributor's area of expertise and experience. For example, in "Fostering the creativity of medical students", the authors Heather Allan, Michele Petrone (who painted the striking cover art), and Deborah Kirklin provide useful guides for teaching creative writing and art production by students studying cancer and genetic disease.

In a particularly insightful chapter, "Medical humanities for postgraduates: an integrated approach and its implications for teaching," Martyn Evans describes the challenges of developing a full-fledged interdisciplinary program for graduate as well as undergraduate studies in Wales. He addresses concerns about "bolt-on" versus integration of medical humanities in the curriculum, risks of superficiality, and how such studies may transform the culture of modern medicine. Several chapters address a theme (such as "clinical detachment" or understanding the patient's perspective) and include topic-specific sources and guidelines.

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To Render the Lives of Patients

Charon, Rita

Last Updated: Nov-16-2001
Annotated by:
Woodcock, John

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

The author, an internist and medical educator with a long-term interest in literature (she recently was awarded a Ph.D. in English literature), describes the literary exercise she uses to develop empathy in students taking her required course in medical interviewing. Charon has her students choose a difficult medical encounter from their own recent training and then write, using the first person, the story of that patient’s life in the day before the difficulty--including being treated by the medical student who is doing the writing. Because much of the story must be imagined, the writer’s intuition is automatically brought into play.

Because it is told from the patient’s point of view, the medical student is forced to see the patient whole and without reference to medical terms. Charon argues that this exercise of the imagination yields a combination of objectivity and empathy that forms the basis for good medical care. She also finds that the exercise helps medical students see themselves as their patients see them--and thus to understand, for instance, the effect on their patients of their youth and nervousness.

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Annotated by:
Shafer, Audrey

Summary:

Levin, a social documentary photographer, immersed herself with the Class of 2001 in the anatomy course at Weill Medical College of Cornell University. Her photographs of cadavers, students and instructors are prefaced by a foreword by physician-writer Abraham Verghese. He describes the rite of passage of anatomical dissection: "The living studying the dead. The dead instructing the living." (p. 9)

Interspersed with the full-color images are journal entries by 11 medical students and several artistic anatomic illustrations by 3 of the students. The journal entries and photographs are organized temporally, from the introduction to the dissection lab to the final exam and student-organized memorial service. The end of the book includes the interests and brief biographies of the 11 students and a final dedication by Levin of the book to those who donated their bodies: "I have never before witnessed a gift that is honored, respected, and consumed so completely."

The photographs are not for the squeamish. For example, the double amputee pelvis prosection on page 102, or the multiple images of flayed skin, bits and pieces, or limbs tied to supports provide an insider's view of an anatomy course. Many of the images show the living in motion: translucent images of students in time-lapse swirl near the static cadavers. Other images conjure the once-upon-a-time personhood of the dead: pink fingernail polish on a female cadaver or a heart palmed by a student. The intensity of the student experience is well documented, as is the relaxed atmosphere that inevitably develops as students become accustomed to the experience of dissection.

The student journal entries are sensitive and thoughtful. Students comment on the intersections of daily living, home life, and their own bodies and bodily functions with what they are learning in the classroom. Particular discomfort regarding certain dissections, such as the pelvic region, are acknowledged. Even though students note growing immunity to the dissection experience, such comments reflect insight into professionalism and defense systems. Gallows humor and uneasiness with such humor is explored by Rebecca (p 62) after she sings "New York, New York" to the roomful of cadavers. Forensic clues about the cause of death for a particular cadaver renew the sense for students that this was once a living, feeling person.

The intense, long hours required for understanding and memorizing the material are clearly evident, but ultimately, these students realize they are given a truly special opportunity: "I began to love learning the material just for the sake of learning. Anatomy no longer felt like a burden, but rather a gift." (David, p. 119) Relationships explored include those of student with cadaver (particularly respect/disrespect, ownership and protection), life with death, and those who have had the experience of dissection with those who never will.

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