Showing 371 - 380 of 429 annotations tagged with the keyword "Professionalism"
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.
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.