Showing 371 - 380 of 561 annotations tagged with the keyword "Physician Experience"

Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Criticism

Summary:

In this short volume, Janet Malcolm frames a series of reflections on Chekhov's life and work with her pilgrimage to Chekhov-related sites in Russia and the Ukraine. The book begins with Malcolm's visit to Oreanda, a village on the Crimean coast near Yalta, which is the site where the fictional lovers in Chekhov's story The Lady with the Dog (1899, see annotation) sit quietly and look out at the sea on the morning after their first sexual encounter. While these lovers are fictional, their creator actually spent the last several years of his life as a respiratory cripple living amid the seascapes around Yalta.

The visit to Oreanda occurred near the end of Janet Malcolm's literary journey, but it provides a fulcrum or center of gravity for the book. From there, she constructs a narrative with three interweaving plots. One consists of her reminiscences of the last 10 days or so in St. Petersburg and Moscow, and her visit to Chekhov's estate (now a state museum) in the village of Melikhovo, south of Moscow. A second presents biographical material about Chekhov. Malcolm triangulates and interweaves these two with critical observations about the writer's stories and plays.

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The Case of Dr. Sachs

Winckler, Martin

Last Updated: Nov-27-2002
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Novel

Summary:

At the heart of this novel is a simple love story. Dr. Bruno Sachs, a slight, stooped, and somewhat unkempt general practitioner in a French village is dedicated to his work and loved by his patients. Sachs is a solitary, self-effacing man who takes his Hippocratic duties seriously and is especially sensitive to the needs of his patients.

In addition to his private practice, Sachs works part-time at an abortion clinic, where he performs an abortion on a distraught young woman named Pauline Kasser. Soon the doctor and his patient fall in love. She moves in with him and becomes pregnant. An editor by profession, Pauline also encourages and assists Dr. Sachs in completing the book he is writing.

The story has many additional layers and dimensions. The reader views Sachs through the eyes of multiple narrators--his patients, colleagues, friends and acquaintances, all of whom write in the first person and present Bruno Sachs as "you" or "he." Thus, the reader gradually builds up a "connection" (empathy) with Sachs by synthesizing multiple glimpses of his behavior and facets of his character. At the same time, Sachs is trying to find his own voice, his own connection, by becoming a writer. At first he jots down random thoughts, then he keeps a notebook, and eventually he produces a complete manuscript.

The book has innovative structural elements that introduce other layers of meaning. For example, the 112 short chapters are organized into seven sections, corresponding with the components of a complete clinical case history: presentation (as in "chief complaint"), history, clinical examination, further investigations, diagnosis, treatment, and prognosis. Similarly, the narratives delve progressively into Sachs' "illness" and follow the "patient" through his course of "treatment."

Another structural element is the cycle of fertility and gestation. The story takes place from September through June, precisely 40 weeks, a pregnancy of nine months, during which Sachs is re-born.

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Cut to the Word

Metcalf, Tim

Last Updated: Nov-12-2002
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

Tim Metcalfe is an Australian general practitioner who gave up medical practice to become a full-time poet and writer. A statement on the back cover summarizes the process in relation to this collection of 38 poems: " ’Cut to the Word’ is a moving account of one man’s transition from doctor to poet." He begins with the customary initiation: "We were introduced, respectfully, / to the volunteer dead . . . " (p. 13) He discovers the limitations and uncertainties of his new profession: "In tense moments / I wish my stethoscope / was all they want it to be." (p. 18) And the omnivorous demands of medicine: "I come home from work / and there it is: the family / the oldest crying / at the youngest crying / at her mother’s anger / at her crying . . . " (p. 21)

Metcalfe carries the reader through a series of short, incisive poems describing the doctor’s day-to-day work ("Morning Session, " pp. 47-50), as well as through a number of disturbing poems about the world of mental illness, but the book’s climax--so to speak--arrives with "The Doctor’s Complaint, " in which the physician heals herself "by laying down her stethoscope / and walking right out / of that in-patient clinic." At the end the poet writes, "Like a patient I have learned silence . . . Fine steel scissors in hand, / I cut to the word." (p. 63)

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D Day, 1994

Coulehan, Jack

Last Updated: Nov-11-2002
Annotated by:
Belling, Catherine

Primary Category: Literature / Poetry

Genre: Poem

Summary:

In this five-stanza free verse poem the speaker, a physician, observes the patient, a young man dying of cancer and suffering pain in the arm he has lost to the disease. The patient watches television, and sees the fiftieth-anniversary commemoration of D Day, the Allied landing in France in World War II. The old soldiers, the war veterans, are enviable for the "honor" provided by the source of their losses and injuries, the sense of meaning that comes from winning a war, which is so unlike the arbitrary and passive suffering of cancer in which, as the speaker says, there's "no honor."

The patient has asked whether a scan would explain the pain in his phantom limb; the physician muses that a scan is the wrong place to look, not just because there is no arm to scan, but because what the cancer patient really lacks is a story which can make sense of and justify his misery. The veterans have such a story. Although they are aging and have suffered, the speaker longs to give his patient "their battles," the sense of significance and value (a story recognized by the whole world, as the TV broadcast indicates) which cancer lacks.

The poet plays with the "D's" of D Day: "deception, danger, death," are all inherent in the world, but seldom accessible to confrontation as they are in war (to this extent war is like the scan, making the sources of pain visible and so manageable). A fourth "D" is added, for "deliverance," implying that the "old men's stories" of battles and victory compensate for their suffering in a way that nothing can for the cancer patient.

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Summary:

This collection is a wide-ranging view of physician poets writing not only about their professional roles, but about themselves and those around them as human beings. The anthology came about as a tribute to one of its major contributors, poet-physician Rita Iovino who spent many years of her life working with other physician writers and their creative natures.

All of the 29 contributors are physicians and the range of subject matter is broad. The collection is divided into subject matter clusters: Of Medical Matters; Of Love Matters; Of Family Matters; Of Natural Matters; Of Life and Death Matters; Of Philosophical Matters; Of Holy Matters; and two prose essays on the role of poetry in the lives of physicians.

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Annotated by:
Woodcock, John

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

In this chapter (no. 43) from his autobiography, Williams seeks to describe the poetry of medicine, the almost indescribable quality (Williams frequently refers to it as "it" and "the thing") that draws him to his practice. Clearly it is not anything medical-technical. He particularly disparages surgery and the idea that you can cure by merely cutting. Rather, it involves seeing each patient as "material for a work of art"(287), by which he seems to mean a natural showing of strong character or selfhood under pressure of difficulty. In a strong central passage Williams calls medicine "the thing which gained me entrance to these secret gardens of the self"(288).

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Christ Stopped at Eboli

Levi, Carlo

Last Updated: Aug-28-2002
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Christ stopped at Eboli, say the southern Italians, meaning that they are "not Christian," uncivilized, forgotten, and deprived. Physician, writer, and painter, Levi was arrested and 'exiled' from his home in Turin for opposing Fascism during the Abyssinian war (1935). This is the memoir of his life as a political prisoner under house arrest in a malaria-ridden village in Lucania (Basilicata).

The peasants immediately seek his advice for their ailments, but the two local doctors are jealous, as well as incompetent, and they have him stopped. Grinding poverty, illness, superstition, and despair work on each individual in different ways; but the peasants move with the cycle of seasons and religious festivals. The feast of the black Madonna (Chapter 12) and an unforgettable pig castration (Chapter 19) are vividly described. In the 'atmosphere permeated by divinities' (p. 151), the animal, human, and spiritual spheres combine (Chapters 8, 13, 15).

The closing chapters are a political meditation. Deprivation and isolation make the south an irrelevant and different country to the powerful middle class that runs the Fascist party. In return, Fascism finds no supporters here other than corrupt, petty officials. Levi contends that "the State" of any political stripe will never solve the problems of southern Italy until peasants are involved.

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The Breast Cancer Wars

Lerner, Barron

Last Updated: Aug-28-2002
Annotated by:
Holmes, Martha Stoddard

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

Written by a medical historian who is also a physician, The Breast Cancer Wars narrates how breast cancer diagnostic methods and treatments have developed from the early twentieth century. More significantly, the book describes the debates and controversies that permeated this evolution and the ways in which not only clinicians and researchers, but, increasingly, women patients/activists shaped how we view, diagnose, and treat breast cancer today.

Individual chapters explore the influential (and ultimately contested) radical mastectomy procedure of William Halsted, the development of the "war" against breast cancer as a full-blown campaign developed and conducted within the public media and consciousness of the United States as well as within medical practice and research, the intertwined development of feminism and breast cancer activism, the "fall" of the radical mastectomy, and the continuing controversies surrounding mammography and genetic testing as modes of early detection and risk assessment. Lerner draws on a range of primary sources including texts from the archives of the American Cancer Society, the papers of doctors and patients, and advertisements from popular and professional magazines throughout the century.

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La Tendresse

Strauss, Ken

Last Updated: May-30-2002
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Novel

Summary:

The novel begins with a prologue in which the author reports that, while repairing an old chateau he had purchased in the north of France, he discovered a manuscript ("La Tendresse") hidden in one of the chateau's chimneys. Dr. Alain Hamilton, the manuscript's author, had hidden it there, as the German army approached the chateau in 1940. "La Tendresse" was a collection of writings that described Hamilton's early life, especially his experience as a battlefield surgeon in the British army during the First World War. The 80 short chapters that follow, Strauss explains, are an edited and annotated version of Dr. Hamilton's story.

We first meet Alain Hamilton as an adolescent, during an episode of sexual awakening with a girl his own age. Later, we see him as a medical student in Vienna and then as a young married surgeon in London, who has a tender affair with a married nurse. But most of the story takes place at a British Army field hospital, where Dr. Hamilton encounters the senselessness, devastation, and absolute terror of war.

His colleague in this tragedy is Elizabeth, a nurse whose brother and fiancé have died in the fighting. Alain and Elizabeth develop an exquisitely tender, yet unconsummated, intimacy, which ends tragically. After the war, Alain searches healing and consolation, eventually finding a measure of peace in the chateau where he and Elizabeth had once worked together.

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By the Bedside

Vivante, Arturo

Last Updated: May-30-2002
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

A woman lies in her bed, dying of cancer. Several family members have gathered in the room around her, including her son Bruno. From the age of 11 Bruno had wanted to be an artist, but had become a doctor instead because it was easier to make a living. "And medicine at one point--when he was nineteen or twenty--had seemed more humane than the humanities, more artful than art." Yet four years earlier, Bruno gave up his medical practice in Rome to devote his life to painting. But now he is back to medicine, helping to coordinate the efforts of his mother's physicians.

The dying woman sips an opium solution to ease her pain. She teases Bruno about the many times she had embarrassed him as a child, by acting funny or assertive or eccentric, behaving very differently from the other children's mothers. She would always make people laugh. Likewise, she was never confused about what she wanted. Even now, tipsy with opium, she remains in charge, a rock among the gathered family members, deflecting their sadness with her good humor.

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