Showing 361 - 370 of 425 annotations tagged with the keyword "Professionalism"
Dr. Ernest Lash, single and around 40, discovers his enthusiasm and love for psychoanalysis, the talking therapy, after several years of practice as a psychopharmacologist. As the novel opens, we meet a smart, somewhat smug and self-absorbed Dr. Lash who practices from his office located in the privileged community surrounding Sacramento Street in San Francisco. He has an active psychoanalytic practice, ambition for respect and notice by the seniors of his professional community, and some aspiration to greater success as a theoretician and writer on the subject of psychoanalysis. Central to his character is a love for his work, where it appears that pride in technique and outcome shadows genuine concern for his patients and their unhappiness.
Early in the novel, a male patient, Justin, who has been working with Ernest for several years, announces that he is leaving his wife, Carol, for another woman. Ernest is pleased since he views the marriage between Justin and Carol as unhealthy, while a bit dismayed that Justin fails to acknowledge Ernest's contribution in helping Justin develop the confidence to take this step. Justin ends his relationship with Ernest Lash--feeling that he no longer needs his help--as the beginning of the novel takes an intriguing direction.
Justin's now abandoned wife, Carol, in a state of betrayal and desire for vengeance--she has a hateful attitude toward all psychiatrists after her psychotherapist of many years ago had an affair with her--decides to enter therapy with Dr. Ernest Lash in the hope of seducing him. She disguises herself with a name change and enough distortion of her past and present so that Dr. Lash will not be able to connect her to Justin. She wishes to expose him as a charlatan, and destroy his career.
Carol is an attorney, and smart. Dr. Ernest Lash is lonely and drawn to Carol. The therapy sessions and the progression of their relationship are central to Yalom's exploration of the intersubjective experience, where strangers struggle with the ambiguity of their own motives and intentions in the intimate world of psychoanalysis. Who is giving, who is receiving? Who is being helped, and who is helping?
Yalom weaves this central element of the plot with many other relationships. Dr. Marshal Streider is a senior psychoanalyst with ambitions for national recognition and a preoccupation with money. He is Dr. Ernest Lash's supervisor. He takes great pride in the fact that he treats many wealthy patients, and is engaged in his own boundary dilemmas when he invests, using insider information from one of his patients.
Dr. Seymour Trotter is a senior psychoanalyst who is condemned and removed from psychoanalytic practice after entering a sexual relationship with one of his patients. We learn that Seymour Trotter was once president of the American Psychiatric Association, and a mentor to Marshal Streider. His maxim, "My technique is to abandon all technique" (p. 7), both haunts and guides Ernest Lash throughout the novel as Ernest grapples with his own passions and temptations, while striving in his goal to achieve humane and healing therapy for his patients.
At Christmas, 1913, the two Rappard boys and their grandmother (May Robson) bring a cake to the Brussels nursing home where the English matron, Edith Cavell (Anna Neagle), is caring for their dying mother and many small children. The prayer is for peace, but in a few short months war has spread over Europe and the oldest boy is sent to fight.
He is taken prisoner, but escapes to the nursing home because he hears that Germans are shooting prisoners. Cavell, with a network of friends including the boys' grandmother, the barge-owner Mme Moulin (ZaSu Pitts), and a dignified Countess (Edna May Oliver) help him and two hundred other wounded young men to escape into Holland and France.
By August 1915, Cavell and her friends are betrayed by a German spy and put on trial. Despite international pleas for her release or detention, she is shot at dawn on 12 October 1915. Linking nursing to religion, the priest who attends her final hours tells her, "it is God's will," while the hymn, "Abide With Me," sung in the final scene of her 1919 memorial service at Westminster Abbey, reminds viewers that she had been "help of the helpless."
A story with several implications for the profession of medicine, this short tale concerns three itinerant surgeons who "thought they knew their art perfectly." Boasting of their surgical/curative skills, they state that they will be able to re-attach their own body parts--hand, heart, and eyes--which they propose to excise. The body parts are entrusted to an innkeeper's servant girl to be saved overnight, but instead they are eaten by a cat.
Unbeknownst to the surgeons, substitutions are made: the hand of a gallows thief, the eyes of a cat, and the heart of a pig. These the surgeons successfully re-attach to themselves. But the organs confer on the transplantees the characteristics of their original owners (thief, cat, pig). Blaming the innkeeper for their problems, they threaten to burn down his inn unless he gives them all the money he can raise. This sum allows them to live comfortably, "but they would rather have had their own rightful organs."
Perri Klass, who had already written of her medical school education (A Not Entirely Benign Procedure: Four Years as a Medical Student, see this database), took notes, made dashed journal entries, and saved sign-out sheets and other written memorabilia during her internship and residency in pediatrics at The Children’s Hospital in Boston, Massachusetts. Because she is a writer, she looked at her experiences in medical training with an eye towards what stories were happening. This book then is a compendium of stories and essays (some previously published) about Klass’s pediatrics training.
Klass reflects on the difficulties of being a writer and physician: "I have been a double parasite, not only learning off patients, but also writing about them, turning the agonies of sick children into articles, using them to point little morals either about my own development as a doctor or about the dilemmas of modern medicine." (p. 297) But she also notes the benefits of writing during training: "between life at the hospital and with my family, it seemed that all my time was spoken for, and spoken for again. I needed some corner of my life which was all my own, and that corner was writing . . . I could describe the astonishing contacts with life and death which make up everyday routine in the hospital." (p. xvii)
Part of the book concerns issues of women in medicine; Klass debunks the mystique of the "superwoman"--the professional, wife and mother rolled up into one incredible ball of efficiency and perfection--with a month of laundry spilling over the floor. Klass, as a successful writer, struggles with this label and includes an essay on her experiences with a "crazy person" who anonymously and publicly accuses her of plagiarism in the midst of the stress and responsibilities of residency.
However, most of the book is about being a new doctor--the terror, the patients, the procedures, the other doctors and staff. She writes of first nights in the Neonatal Intensive Care Unit, delivery room crises, adolescents with chronic illnesses, and her struggles as a sleep and time deprived mother.
She addresses difficult issues: moral dilemmas, suffering, loss, the rape and abuse of children, children with AIDS. Throughout the book is a concern for the patient’s experience, as well as the doctor-in-training’s experience. After her first night on call caring for very premature infants she notes: "Maybe my first patient and I have more in common than I realized: we are both too immature to be out in the world, but with a lot of help, we may just make it." (p. 15)
This history of western medicine in the nineteenth century chronicles the lives of some men and women who were innovators in the field of medicine. Williams begins the book in the 1700s with the life of John Hunter and his influence on nineteenth century medical practice and research.
The book consists of 16 chapters, many of which, like the one on Hunter are biographic. For example, Williams writes of the contributions, education, and lives of Florence Nightingale, Hugh Owen Thomas (orthopedics), Marie Curie, Joseph Lister, Ignaz Semmelweis (maternal health), Patrick Manson (tropical medicine), Jean-Martin Charcot, and William Conrad Röntgen. Other chapters are more theme-oriented, such as body-snatchers, discovery of anesthesia, homeopathic medicine, blood transfusion, and medical use of spas.
Black and white illustrations, such as Mrs. Röntgen's hand in an X-ray photograph help the reader to appreciate the advances in medical knowledge in the nineteenth century.
The young English doctor, Mary Percy Jackson (M.D. Birmingham 1928), went to practice in northern Alberta for a year. She had been recruited by a philanthropic movement that targeted women doctors: they could be paid lower wages and would also cook and keep house. But she fell in love with the subarctic community, its native peoples, and a certain widowed farmer with two young sons, and stayed for the next seven decades.
Dr. Jackson became the only physician responsible for the well being of aboriginals and settlers in a wide radius of remote territory where winters last more than six months and the only effective mode of transportation was the horse. Married and in relative prosperity, she did not seek payment for her medical work, although she appreciated gifts in kind.
Despite the isolation, Jackson was vigilant about nutrition, vaccination, and tuberculosis control and she kept up with the latest advances in health promotion. She and her husband were active in improving opportunities for education. The film closes with a simple party for Jackson, at the local school named in her honour.
Dr. Pensack writes in the first chapter of his memoir: "Through a lifetime I have been in the process of dying, consistently surprised when reminded that life is appallingly brief, and briefer still for me. The prospect of an early death has amounted to little more than embarrassment and loneliness, even though the routine of living can be, and usually is, just one goddamn thing after another. A new heart was somehow supposed to be my bloody-red carpet of victory." (p. 7)
At age 4, Pensack's mother died of IHSS, Idiopathic Hypertrophic Subaortic Stenosis--now known as HCM, Hypertrophic Cardiomyopathy, a genetically inherited, progressive disease of heart muscle that results in early death. At age 15, Pensack receives the terrible news of his own fate--the disease afflicts both Pensack and his older brother--and thus launches a life of near death experiences, numerous hospitalizations, early experiences at the National Institutes of Health with early investigators of the disease, pursuit of his own medical training and eventual specialty training in psychiatry, marriage and children, and ultimately, the waiting and eventual transplantation of a younger man's heart into his chest at the University of Colorado Health Sciences Center when Pensack was 43.
Raising Lazarus tells of Pensack's journey through much of this, including his descent into madness, his fury and anger with medical colleagues, his poignant relationship with the heart surgeon who eventually performs the transplant, and the importance of his family in his refusal to die. While much of the book tells of the events leading to the transplant and post-operative period of Pensack's life, the reader learns of Pensack's early losses, including the death of his mother, and how these experiences shape the values of a gutsy and determined survivor, a man who continually returns to the struggle.
Coulehan speaks to the cadaver (Ernest), beginning with factual observations about his damp face and beard. He then becomes confessional--in fact, by directly paraphrasing the traditional Catholic formula of confession ("Bless me, father, for I have sinned . . . "). He implores the cadaver to reveal himself, to yield the truth of his condition.
In the last stanza, the tears of conjunctival irritation (formaldehyde) become tears of sorrow "for all offenses / to the heart . . . " and "for the violence / of abomination . . . . " Cutting up a corpse is an "abomination," but one that must be accepted and transcended in order to gain the power to heal. In the end, the tears become life-giving rain on the canyon wall.
This essay is told from the perspective of an ophthalmologist who was consulted about a patient who had blurry vision. She is told by his internist that he has cancer but the family does not want him to know it. She plays along with the deception and does not inform the patient that his vision problems are from brain metastases. By serendipity she later learns that the patient knows his diagnosis but is playing along with the deception so as not to hurt his family. She is relieved to finally talk with him openly about his disease and his prognosis.
Summary:A psychiatrist who is skilled at hypnotism is asked by an oncologist to hypnotize a difficult patient prior to a bone marrow biopsy. The psychiatrist is able to achieve excellent pain relief through hypnotism, much to her own surprise. She is exhausted by the mental energy she has expended in this experience, and is discredited by the oncologist, who doesn't really believe that hypnotism is anything special.