Showing 371 - 380 of 425 annotations tagged with the keyword "Professionalism"
A pediatric intern encounters her first dying child. Her initial response is to care for the child, hold him, and try to comfort him. She is told by her attending physician that this behavior is unprofessional. When she cries in response to her stress and grief, she is told she will never be an effective physician. The narrator then describes how she ultimately came to terms with her impulse to cry at stressful times, and how she interacts with patients in her current practice.
The thirty-four autobiographical essays were written while Klass was a medical student in the Harvard class of 1986. Many of her short chapters were previously published as columns in magazines, journals and newspapers. The insightful but often funny stories cover a variety of scientific and clinical subjects, lifestyle, eating habits, and relationships with other professionals, including nurses.
Pregnancy and the birth of her son half-way though training makes her experience somewhat unusual. In several other essays, including "Macho" and "Learning the Language," Klass reveals her particular sensitivity to language and the advantages and disadvantages of professional discourse.
Sidney Winawer is a New York physician specializing in gastrointestinal cancers. When his wife, Andrea, is diagnosed with stomach cancer, he is made to see his own work from a new perspective, that of the patient and her family. The experience gives him new insights into aspects of health care he had not considered before, such as the alienating effects of some hospital routines on patient and family, the patient's need to find hope from any source, regardless of its intellectual provenance, and, encouragingly, the life-enhancing effects on his family as they join Andrea in her determined struggle to prolong and enrich whatever time remains for her.
For the first time, Winawer explores alternative and complementary approaches to cancer treatment, including meditation, antioxidant therapies, hyperthermia, and other attempts to stimulate the immune system. At first resistant, he comes to recognize the need for the terminally ill and their families to have access to as many resources as possible, and eventually it becomes his "mission" to emphasize the need for practitioners of conventional medicine to learn as much as possible about integrative medicine.
An interesting subplot is the story of Dr. Casper Schmidt, Andrea's psychiatrist, whose remarkable knowledge of new treatments for terminal illness is explained when he dies of AIDS. As another physician led by personal experience of disease to explore beyond the boundaries of conventional therapies, Schmidt forms an illuminating counterpoint to Winawer himself.
In this remarkable book of essays, Rafael Campo explores his coming-of-age as a gay Cuban-American physician. He presents us with a series of stories illuminating his childhood and college experience, skillfully interweaving them with narratives from his life as a young physician, especially his interactions with patients dying of AIDS. We follow the author from Amherst College, through Harvard Medical School, to his medical residency in San Francisco. At each step Campo is a close observer of human character and motivation--his own and others. At each step he asks, "Who am I? Who am I becoming?"
He discovers his identity as a gay man, an Hispanic man, a poet, and, finally, as a healer--not four identities, but one. He discovers, too, the healing power of connecting with patients, the "poetry of healing," something far different from the orthodox image of the physician-as-detached-or-distanced from his patients. Though Campo rejects the concept that physicians are agents for social change ("naive," he calls it), he brings sensitivity and poetry to bear on his continued search for "some way to give."
Linda Bishop tells the story of her early years as a nursing student. She soon realizes that she doesn't actually want to be a nurse, but she continues in training, "waiting for some unspeakable horror that I could hold up to the light to prove to myself that the hospital was a truly monstrous place."
While Linda is quiet and sexually inexperienced, her first roommate, Holly Bostwick (Boss), is reputed to have a sensational sexual history and to be afflicted with syphilis. When Linda brings Holly home for Thanksgiving, Linda's mother is impressed with her daughter's new friend, a young woman much more confident and articulate than ambivalent Linda.
Somewhat later, after Boss becomes engaged to a gas station owner, Linda returns by train from visiting her parents. She is determined to make a final decision. She lists what she hates about the hospital and what she likes about it. Will she leave or will she stay?
Stella is the wife of Max Raphael, the deputy superintendent of a maximum security psychiatric hospital near London (based perhaps on Broadmoor, where the author's father was medical superintendent), and mother of a ten-year-old son. She becomes involved in an obsessive sexual affair with one of the institution's patients, Edgar Stark, a schizophrenic sculptor institutionalized after murdering and decapitating his wife.
Stark uses his affair with Stella to escape, and she runs away to London to join him. After a few passionate but squalid weeks in hiding, Edgar's illness resurfaces, evinced both in the violence he shows to a sculpture he's making of Stella's head, and in his paranoid jealousy. She runs away from him and is captured by the police and returned her to her husband, who has been fired because of his wife's role in the escape of so dangerous an inmate.
The family moves to a remote hospital in North Wales, where Max has a minor position, and Stella becomes severely depressed, to the extent that she stands by helplessly as her son dies in an accidental drowning. As a result, she is institutionalized--she returns to the hospital, not as the superintendent's wife, but as a patient. Edgar has meanwhile been recaptured (in North Wales, seeking out Stella either to take her with him or to kill her), but they never meet again, for Stella commits suicide.
Matthew Modine plays Joe Slovak, son of a West Coast fisherman, who goes to medical school and has a hard time adjusting. The film focuses on Joe and the members of his dissection group in Gross Anatomy. Joe, perhaps because of the proud independence of fishermen, goes through most of the film with a big chip on his shoulder, refusing to take things seriously, showing up late for dissection carrying a basketball, refusing to consider the feelings of hypothetical patients, etc., while everyone else is trying their hardest to become good doctors. He falls in love with dissection partner Laurie Rohrbach (Daphne Zuniga), but he has a hard time there, too.
When Joe's roommate David is kicked out, Joe goes home to think things over. He visits Dr. Rachel Woodruff (Christine Lahti), head of Anatomy who all along has been critical of his attitude but is now at home, incapacitated with lupus. She tells him of her disappointment in her own career ("I made doctors--people need healers.") and in him, because he has never wanted to be as good as she knew he could be. She pleads with him to commit to being a good doctor.
Switch to the group's all-nighter before finals and the sudden labor pains of the very pregnant member. They all rush off to the hospital, but don't make it, and Joe winds up delivering the baby on a table in a roadside diner (soft trumpet fanfare from the soundtrack). Between Dr. Woodruff, who dies at the end, and the delivery, Joe gets the message about commitment, and he winds up with both good grades and the girl.
A woman medical student finds herself in a hierarchical dilemma while rotating through her internal medicine clerkship. She is helping to take care of a middle-aged man who has been hospitalized for a diagnostic work-up. As a consequence of invasive procedures ordered by his physicians to determine the cause of his symptoms, the patient has suffered serious complications and is moribund. The doctors are evasive with the patient and his family, who beseech the medical student for an explanation. Even though she has been instructed by the physicians to refer all issues back to them, she follows her own convictions and tells the truth: "Your father is dying."
As a result of this "insubordination," she is called in to see the head of the department, a man of "legendary diagnostic skill" with a long tenure at the hospital. He says that he will have her dismissed, and launches into a long diatribe, making the case for a paternalistic medicine in which the patient needs to believe that the physician is omniscient and possesses quasi-magical healing powers. "Miracle, mystery, and authority," he says, are at the heart of what physicians can do for their patients and to undermine these is to do harm to the vast majority of the sick. Having made his point, he terminates the interview but reinstates the student, who, it is suggested, is so grateful (for his advice or for not being dismissed?) that she kisses him.
William Morton first introduced ether anesthesia in 1846. This was followed shortly by nitrous oxide and chloroform. Within a few years, surgical anesthesia was being used throughout the United States. However, widespread acceptance did not mean universal usage. Physicians and surgeons debated the risks and benefits of anesthesia. Anesthesia was thought to be dangerous. Some argued that pain was a necessary part of life, that it made people stronger, and/or that it was a punishment from God. Others argued that anesthesia constituted an abuse of medical power.
Surgeons took care to select appropriate patients for anesthesia, while performing surgery without anesthetics on others. Women, people of higher social and economic classes, and people of the white race were thought to be more sensitive to pain than men, the poor, and Negroes and American Indians. Likewise, the young experienced pain more than the elderly. Certain procedures (e.g. major limb amputations and prolonged tissue dissection) were also thought to require more anesthetic than others (e.g. natural childbirth or ENT surgery). These beliefs carried over into practice, as evidenced by records from the Massachusetts General Hospital and other hospitals in the mid-19th century.
In his study, Professor Starr examines the evolution of the practice and the culture of medicine in the United States from the end of the colonial period into the last quarter of the twentieth century. His major concerns are with the development of authority, and the Janus image of professionalization as medicine has gained power, technical expertise, and effective modes of diagnosis and treatment and at the same time seems to be getting further from the patient.
At the time of publication, our society had finally begun to take a hard look at the impracticality and the inhumanity of continuing on the trajectory of American medicine developed one hundred years ago. Starr invites the reader to consider the impact of modern stress on the profession and, more intently, on the constituency it is dedicated to serve.