Showing 371 - 380 of 484 annotations tagged with the keyword "Art of Medicine"
Seeking redemption in the bloody business of surgery, Selzer's narrator tells several medical stories that humbled his surgeon's pride and refers approvingly to an atheist priest in a story by Unamuno who carried on for the sake of his congregation because "their need is greater than his sacrifice." Selzer finally tells us that it is in writing, if anywhere, that the elusive soul can be represented.
The Exact Location of the Soul is a collection of 26 essays along with an introduction titled "The Making of a Doctor/Writer." Most of these essays are reprinted from Selzer's earlier books (especially Mortal Lessons and Letters to a Young Doctor). Six pieces are new and include a commentary on the problem of AIDS in Haiti ("A Mask on the Face of Death"), musings on organ donation ("Brain Death: A Hesitation"), a conversation between a mother and son ("Of Nazareth and New Haven"), and the suicide of a college student ("Phantom Vision").
This is a collection of humorous sketches first published in 1850. They purport to describe the youthful experience (and antics) of an elderly "swamp doctor" named Dr. Madison Tensas. In fact, they are the work of Henry Clay Lewis, a young Jewish-American doctor who, after graduating from the Louisville Medical Institute in 1846, set up practice in MADISON County, Louisiana, along the banks of the TENSAS River.
The Introduction of this edition, written by Edwin T. Arnold, locates Henry Clay Lewis and his work within the context of 19th Century "South and Southwest Humor," and briefly discusses each piece. One of his major points is that the swamp doctor's "odd leaves" contain a dark, almost Gothic strain, thoroughly mixed in with their humorous and prankish sensibility. (Perhaps "lack of sensibility" would be a better phrase to use to describe these sketches.)
The first brief sketch compares characteristics of the "city physician" with the "swamp doctor." After this, we follow the growth and development of "Dr. Tensas" from childhood through medical school and into his practice in the swamp country of Louisiana. Among the more notable sketches are "Getting Acquainted with the Medicine," in which the student's preceptor conceals his bottle of whiskey by labeling it "tincture of arsenic"; "The Curious Widow," in which the student prepares a gristly surprise for his snooping landlady; "Being Examined for My Degree," which demonstrates the comic vagaries of oral examinations; "My First Call in the Swamp," in which the newly minted doctor cures his first patient (more or less); and "How to Cure Fits," which presents a novel and efficient treatment for hysterical disorders.
If you want to find some genuine clinical wisdom in this book, look no further than "My First Call in the Swamp," where the author observes, "if you wish to ruin yourself in the estimation of your female patients, hint that the disease they are laboring under is connected with hysterics" (p. 146).
Zimmer's poem begins with policy guidelines for landlords whose elderly tenants may be calling the switchboard more than three times per month for health emergencies. According to the guidelines, such patterns suggest that the resident, no longer capable of independent living, can be moved to a health care center.
In response to the policy passage, an advisory poem is constructed by the narrator for his own father who, we can assume, values his independence. In essence the son advises silence about medical events such as a fall: "tell no one." If an ambulance should arrive, don't get in.
The strong warnings reflect contemporary health care systems in which the prevailing practices correspond to Dante's Inferno, particularly the tenth circle. At that level, everyone faces one direction and people are "piled like cordwood inside the cranium of Satan." Cries for help are unheard and unanswered.
In his first chapbook of poems, Richard Berlin, a psychiatrist, writes about his current work with patients ("What a Psychiatrist Remembers," "Rough Air," "Berlin Wall," "Jumpology"), about his experiences on medical wards and as a student ("Anatomy Lab," "Sleight of Hand," "Alzheimer's Unit," "Obstetrics Ward, County Hospital"), about love and family and how medicine sometimes infiltrates even these sanctuaries ("How JFK Killed My Father," "Tools," "Our Medical Marriage") and, most effectively, about the complexities inherent in the role of physician and healer ("What to Call Me," "After Watching Chicago Hope," "Code Blue," "What I Love"). In other poems, he observes the human condition through the veil of medicine ("Hospital Food," "PTSD").
The lure of these poems is Berlin's facility with metaphor; he has a talent for spinning a particular image or observation into revelation. He is also willing to allow puzzlement, doubt, and fear into his poems, effectively conveying both the virtuosity of the teacher and the wonder of the student. Reading this collection, I felt as if the poet was a presence both within the poems and outside of them, like the psychiatrist who must enter the mind of the patient and, at the same time, step back and become a safe guide. It is this double vision that sets his poetry apart.
This brief autobiography, written when Schweitzer was mid-50's, summarizes his life and thought up to 1931. He presents illustrative factoids and incidents from his childhood and student years, then briskly covers his development as a minister, philosopher, biblical scholar, musician, and musicologist, all before he reaches Chapter 9 (p. 102), which is entitled, "I Resolve to Become a Jungle Doctor." He greatly enjoyed his life as a scholar, yet was plagued by "the thought that I must not accept this happiness as a matter of course, but must give something in return for it." (p. 103)
He was particularly struck by the fact that so many people in the world were "denied that happiness by their material circumstances or their health." At around this time (1904), Schweitzer came across a publication of the Paris Missionary Society, which described the needs of their Congo mission. This article changed his life. In 1905, at the age of 30, he enrolled in medical school at the University of Strasburg. (Thus, Schweitzer became a forerunner of today's nontraditional applicants who leave other promising careers to enter medicine.)
Schweitzer and his wife began their work at Lambaréné in Gabon, West Africa, in 1913. As a result of the Great War in late 1917, they were sent back to France and detained as enemy aliens until mid-1918. They returned to Lambaréné and rebuilt the hospital in 1924. Between then and 1931 when Out of My Life and Thought was written, Schweitzer devoted most of his time (as he would for the rest of his life) to doctoring at his hospital in Gabon.
This memoir also includes brief intellectual asides describing many of Schweitzer's famous works, such as The Quest of the Historical Jesus (1906), J. S. Bach (1908), On the Edge of the Primeval Forest (1920), Philosophy of Civilization (1923), and The Mysticism of Paul the Apostle (1930).
This memoir begins in Africa, where Dr. Grim is with Médecins sans Frontières managing a meningitis outbreak in Nigeria. Conditions are appalling, but she has come here because of burnout: "so I won't be back home and in the ER" (11). Later in the book, she describes her other "escapes" from the Emergency Room, caring for war refugees in the Balkans.
The book centers, however, on life in an American emergency department, as Grim remembers it from the vantage point of Africa (where she does eventually become nostalgic for well-stocked supply cupboards and a more comprehensible chaos). She organizes her stories into a series of "Lessons in Emergency Medicine," in which she addresses the reader directly. After going through a step-by-step account of death in the ER, illustrated with several moving and alarming cases, she concludes: "Congratulations: you have successfully declared someone dead. Now, as an encore . . . you'll get to do it all over again" (28).
The ironic, even bitter, tone warns us of the difficulty of working in such perpetually crisis-ridden circumstances, but it does not conceal a vulnerability that seems necessary to doing the job well, such as when Grim has to tell a family that the father has died of the heart attack he had at his daughter's wedding: "you just stood there," she says, "looking at the corsage, the tuxedo and the pearls . . . You had no idea what to say and you don't really remember what you finally came out with" (26).
The stories are organized around several lessons: "How to deliver a baby," "How to crack a chest," "How to write a prescription" (which includes a discussion of addiction to prescription medication and a withering account of the doctor who overprescribes), and, as if it's as inevitable as the rest, "How to burn out."
By the book's final chapter, emergency medicine has merged, along with the vaccination of refugee children and the impossibility of treating tetanus in Nigeria, into the story of almost unreasonable determination in the face of endless frustration--but this, Grim shows in her final chapter, "Why I do what I do," is the point. Against this backdrop her final story, about the rescue of a child, makes its point: the feeling of saving a life explains all the rest.
Divided into three titled sections: "What Man Might Kill," "The Nurse's Task," and "The Body Flute," the poems in this volume detail moments in the life of a nurse who is also a mother who once [in imagination] dragged her daughter from a wrecked and burning car; a daughter who stood on the stairs and listened to her mother's voice; and a lover who is aware of how her own trained clinical gaze and the gaze of desire sometimes intersect.
The poems range from a whimsical reverse-reel footage of memories that reach back to the moment of conception in "The Smoke We Make Pictures Of" to a scene from childhood when she was rushed to the hospital and came home vowing to love like the "women in white bright enough to burn / running with me in their arms"--a love she describes as "Fierce. / Physical," to a poem that imagines the life of the murderer, to poems that let us into the intimacy of a nurse keeping vigil by the dying, cleaning shriveled bodies, attending women giving birth. "I Hear the Cries of Women" is a litany of memories of "Women in the clinic waiting room" who "wanted to please / wanted to be whole / had no choice / couldn't speak / wasn't heard."
Stark and striking, these poems revel in language that calls suffering by its many names. They alter the distances we keep on pain, reframe what we are repelled by and honor the gritty, sometimes gory work of nurses who are willing to imagine the lives of their patients and lean close over the stink of decay to bless the dying.
In the first section of the book ("Rejected Prayers"), Liveson proves that the prayers were not rejected; rather, they resulted in a group of thoughtful and moving poems. These poems speak eloquently of suffering patients, especially the elderly and neurologically compromised; for example, "Jenna," wearing her "diapered dress" (p. 16), "Sonnet to Sarah," who "lets her fingers trace the pattern on the wall," (p. 20), and the patient in "Praxis," whose "smile was rare but even" (p. 21).
These poems also speak passionately of social and historical pain, and of injustice writ large. Some of the most powerful are in the section called "Before the Plaster Sets," with which the book ends: "My First Death" (p. 63), "Holocaust Torah" (p. 66), and "Yom Kippur, 5760--Musaf" (p. 68).
The latter poem is a kind of contemporary re-envisioning of Allen Ginsburg’s 1956 poem "America." Jay Liveson writes, "Yom Kippur, this is serious. We sit here / hoping to somehow tune the engine / or at least check the map." Is tuning the engine enough? Perhaps we are fooling ourselves; much more needs to be done. How can we be content to sit and tune the engine in this unjust world? Perhaps the poem that speaks this theme most eloquently is "Statistical Causes of Traumatic Shock Syndrome in Gaza--Chart VII" (p. 72).
Narrative competence is important for effective health care practice. By "narrative competence" I mean mastering a wide array of narrative skills, ranging from active listening and empathic responding in the client-practitioner interaction to reflective writing about one's professional experience. In the author's first book (The Therapeutic Potential of Creative Writing: Writing Myself, see this database), she explores the potential of creative writing as an aspect of therapy, and also presents some introductory writing skills. This book overlaps somewhat in covering the background for reflective practice, but focuses in considerably more detail on skill building.
Near the beginning of the book, Bolton presents a clear summary of "The Principles of Reflective Practice" (chapter 2). Recognizing that therapeutic writing is often accomplished in a group setting, the material on "Group Processes and Facilitation" (chapter 4), "The Creation of a Team" (chapter 5), and "Assessment, Evaluation, Mentoring and Values" (chapter 6) serves to introduce the last 100 pages of the book, which address specific writing skills, beginning with "How to Begin Writing" (chapter 8).