Showing 371 - 380 of 470 annotations tagged with the keyword "Medical Ethics"

Souvenir

Phillips, Jayne Ann

Last Updated: Aug-04-2000
Annotated by:
Holmes, Martha Stoddard

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Kate, a doctoral student, has chosen to move far away from the small town in which she grew up and in which her widowed mother (a school superintendent) and brother (an insurance man) still live. Kate's life is solitary, punctuated by unsatisfactory and transitory sexual relationships with men; she has headaches and wonders if "there were an agent in her body, a secret in her blood making ready to work against her" (p. 180).

While her mother disagrees with Kate's life choices, their long-distance relationship is sisterly, playful, and intimate. Kate sends her mother Valentine's Day cards, "a gesture of compensatory remembrance" since her father's death six years earlier (177). One year Kate forgets to send the card; soon after, her mother is suddenly hospitalized for tests that reveal a brain tumor.

Kate's brother insists that if she wants to come home, she must keep quiet about the likelihood of the tumor's malignance and the risk that the upcoming surgery will result in paralysis. He argues that their mother is terrified and that there is no point in making her more afraid. Kate objects to the concealment of the truth but complies unwillingly with her brother's request.

She gains permission to take her mother for a ten-minute walk outside, just time enough to take a ferris wheel ride. As their car reaches the top of the wheel, Kate is clearly upset. Her mother comforts her, saying, "I know all about it . . . I know what you haven't told me" (196).

View full annotation

In the Surgical Theatre

Levin, Dana

Last Updated: Jul-06-2000
Annotated by:
Davis, Cortney

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

In this complex poetry collection (divided into three sections, "Body," "Home," and "World"), the author moves from the specifics of the individual diseased or dying body to the more universal realm of suffering and politics. Not so much a poet of narratives as a conjurer of images, Levin writes from changing points of view: first as a man, then as a woman; as a surgeon, then a patient.

Poet Louise Glück's introduction states that the book's power "derives from ambiguity: the raised scalpel-healing that looks like assault," and Levin's raw imagery is indeed both challenging and celebratory. In the opening poem, "Lenin's Bath," we watch with Dr. Sergei Debov as Lenin's corpse is tenderly submerged in a vat of embalming fluid. Debov imagines the germs that crawl along the cadaver "seeking a way in."

In the next poem, "Eyeless Baby," the reader becomes a caregiver searching a deformed infant's face that is nothing but a single nostril and a cleft palate. In "Bathhouse, 1980," we see (as the blind baby cannot) through a young homosexual man's eyes both the human longing for passion and the viral "scourge" that, again, seeks entrance. The angels that gather in the bathhouse's corner become nurses ("The Nurse") who swarm like moths over a hospitalized patient's body.

This interweaving of place and point of view continues throughout, creating a magical, disturbing world in which a reader can be both body ("The Baby on the Table") and healer ("In the Surgical Theatre"). Other powerful poems include "Personal History," "The Beautiful Names" (in which a young boy learns to name the sexual organs and so discovers their beauty), and "Witness."

View full annotation

Annotated by:
Holmes, Martha Stoddard

Primary Category: Literature / Fiction

Genre: Novel

Summary:

When Ruth's unfaithful and unappreciative husband Bobbo calls her a she-devil, she decides to appropriate that identity with a vengeance and take a different spot in the power relations of the world. She wants revenge, power, money, and "to be loved and not love in return"(49). Specifically, Ruth wants to bring about the downfall of her husband's lover, Mary Fisher, a pretty, blonde romance novelist who lives in a tower by the sea and lacks for neither love nor money nor power.

Ruth commences her elaborate revenge by burning down her own home and dumping her surly children with Mary and Bobbo. She continues on a literally shape-shifting quest in which she changes identities; gains skill, power, and money; and explores and critiques key sites of power and powerlessness in contemporary society, including the church, the law, the geriatric institution, the family home, and (above all) the bedroom.

By the end of the novel, Ruth achieves all four of her goals in abundance. Her success, however, raises complex ethical questions, not only because she uses the same strategies of manipulation and cruelty of which she was a victim, but also because of the painful physical reconstruction of her body that is the tool of her victory.

View full annotation

Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

The author, a Canadian physician-historian-educator, blows the dust off the shelves of medical history with this fascinating text designed for medical students, educators, and those with an interest in history of medicine. Duffin begins this survey of the history of Western medicine with a glimpse at a pedagogical tool designed to spark the interest of even the most tunnel visioned medical students: a game of heroes and villains. In the game, students choose a figure from a cast of characters selected from a gallery of names in the history of medicine.

Using primary and secondary sources, the students decide whether the figures were villains or heroes. The winner of the game is the student who first recognizes that whether a person is a villain or hero depends on how you look at it. This philosophy imbues the entire book, as this treatise is not a tired litany of dates, names and discoveries, but rather a cultural history of the various times in which medical events occurred.

The book is organized by topics which roughly follow a medical school curriculum: anatomy, physiology, pathology, pharmacology, health care delivery systems, epidemiology, hematology, physical diagnosis and technology, surgery, obstetrics and gynecology, psychiatry, pediatrics, and family medicine. The last chapter, entitled "Sleuthing and Science: How to Research a Question in Medical History," gives guidance to formulating a research question and searching for source material. Fifty-five black and white illustrations are sprinkled throughout the book, as well as 16 tables.

Direct quotes from historical figures, such as Galen and Laennec, as well as excerpts from writings of eyewitnesses of events, anecdotes and suggestions for discussion, appear in boxes within the chapters. Many of the chapters contain discussion about the formation of professional societies. Each chapter ends with several pages of suggested readings and the third appendix delineates educational objectives for the book and individual chapters. The other two appendices list the recipients of the Nobel Prize in Physiology or Medicine, and tools for further study, including titles of library catalogues, and resources in print and on-line.

Although the book is a survey covering multiple eras and topics, each chapter contains choice tidbits of detail. For instance, the chapter on obstetrics and gynecology includes the story and photograph of Dr. James Miranda Barry, the mid-nineteenth century physician, surgeon and British military officer, who was discovered to be a woman at the time of her death. The impact of the stethoscope on the practice of medicine is explored in depth in the chapter, "Technology and Disease: The Stethoscope and Physical Diagnosis."

View full annotation

Summary:

This posthumously published collection of essays by Dr. Klawans, an eminent neurologist and writer, explores the interactions between patient, family and neurologist and the implications of specific neurologic diseases. Klawans's special interest in neurology is movement disorders, such as Huntington's chorea and Parkinson's disease, but his outside interests range from evolutionary biology to classical music. His essays, therefore, focus on single patients or families, but the author weaves thoughts about his other interests into each "case."

The book is divided into two sections, "The Ascent of Cognitive Function" and "The Brain's Soft Spots: Programmed Cell Death, Prions, and Pain." In a brief preface, Klawans declares that this book is "more than just a set of clinical tales about interesting and at times downright peculiar patients" from his 35 years of practice, but rather it "humbly grapples with the 'whys' of our brain, not the 'hows.'" (pp. 9-10) In the preface, as well as in one essay, Klawans acknowledges the work and impact of fellow neurologist-writer Oliver Sacks ("Oliver is truly the father of us all." p 12).

The title essay concerns a six-year-old girl who was found, locked and completely speech-deprived, in a closet. Because she is still within the window of opportunity for language acquisition, "Lacey" quickly learns to speak, unlike Victor, the Wild Boy of Aveyron, whose story was immortalized in the François Truffaut film, L'enfant Sauvage. Klawans uses these stories as a launch pad to discuss the evolution of language, including a proposal that the cavewoman, not the man, was responsible for development of the human species as she taught her offspring language.

Other chapters focus on patients with epilepsy, Parkinson's disease, localized and hemispheric stroke, "painful-foot-and-toe syndrome, " and Creutzfeldt-Jakob disease. Two particularly memorable chapters concern Huntington's chorea and Refsum's disease. The chapter, "Anticipation," explores the profound ethical concerns of genetic testing for Huntington's chorea as applied to three generations of one particular family. In the chapter, "The Hermit of Thief River Falls," Klawans recollects his first year as a neurology resident, and his care of a reclusive patient with a rare eponymous illness, Refsum's disease--just in time for a visit by Refsum himself, a famous Norwegian neurologist.

The book concludes with a speculative "afterthought" about genetics, evolution, and the importance of extended "juvenilization" --the protracted post-natal development of Homo sapiens. This essay intertwines some of the threads regarding speech development and evolutionary biology, particularly brain development, that were introduced earlier in the text.

View full annotation

Flying Out with the Wounded

Caston, Anne

Last Updated: Feb-29-2000
Annotated by:
Davis, Cortney

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

This stark and sensual poetry collection is divided into three sections. The first, "Graveyard Shift," introduces the narrator's themes: the keen observation of suffering; the questioning of God's role in such suffering; the way caregivers and patients meld in shared moments of trauma; the struggle to integrate the reality of death and grief into a life outside the healthcare arena.

A longer second section, "Lessons," contains a chronology of poems that broaden the poet's themes. Suffering becomes personal through sexual abuse ("The Burning"), death of a baby ("To the Woman in the Next Bed," "Waiting Room," "Last Lullaby for the Dead Child"), and breast cancer ("Keeping Watch"); the mystery of God's role becomes the narrator's religious quest.

The final section, "The Ones Who Come," opens these themes to the universal: children and adults lost to "the holocausts" of war, poverty, and illness ("Lizard Whiskey: A Parting Gift from Viet Nam," "After the Siege," "The Ones Who Come," "The Man Who Stays Sane"), and how history repeats these cycles of birth, suffering, and death.

View full annotation

Vaccination

Rivera, Diego

Last Updated: Feb-16-2000
Annotated by:
Dittrich, Lisa

Primary Category: Visual Arts / Painting/Drawing

Genre: Charcoal

Summary:

This sketch is teeming with images: in what appears to be a science lab, two researchers stand in the background, surrounded by gray lab equipment; one peers into a microscope. In the bottom of the frame a horse and cow flank three sheep. At the center stands a muscular baby, loosely draped in a white cloth and held up by a nurse in a white apron and cap. To his left stands a rather grim looking doctor, who holds the baby's arm with one hand and injects a vaccine with the other.

View full annotation

A Drink of Water

Brown, III, T. K.

Last Updated: Feb-11-2000
Annotated by:
Belling, Catherine

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Fred McCann is an energetic man in his thirties, something of a playboy, when the Second World War breaks out. He becomes a soldier, and in an Italian village one day he goes to a pump for a drink of water. The pump is booby-trapped and explodes. He is blinded and loses all four limbs. The story traces the development of a relationship between Fred and Alice, his nurse in the military hospital.

As he learns to submit to being entirely helpless, reliant on Alice for all his needs, he gradually begins to adapt to his new condition. Then Alice changes everything by having sex with him. At first their new and obsessive relationship makes him happy, restoring some of his old sense of himself as a man. When Alice is moved to another duty and replaced by a sadistic male nurse, Fred is so devastated and makes such a scene that he gets Alice back.

To celebrate her return, Alice sneaks some whiskey into his room and they get drunk. She then says something that appalls him: she calls him her "thing" and confides that she has always hated men, who look at her and touch her and have power. Fred is nauseated, seeing himself reduced to nothing more than a "a phallus on its small pedestal of flesh." He realizes now that he is no longer a man, and later that night he manages to drag himself out into the garden, where there is a small pool in which he drowns himself.

View full annotation

Somewhere in France

Gardiner, John Rolfe

Last Updated: Jan-24-2000
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Novel

Summary:

An American physician's life is irrevocably bisected by World War I. Before volunteering for medical duty in the war, Dr. William Lloyd's existence was structured, safe, and even obedient. After his experience supervising a hospital in France, his life becomes uninhibited, tumultuous, and eventually dangerous.

After the war ends and he returns home, Dr. Lloyd soon divorces his wife and leaves his family. He returns to Europe with the sole purpose of being reunited with Jeanne Prie, a bewitching and extraordinary nurse he worked with in France. She is also a dedicated microbiologist and possesses some of the characteristics of Joan of Arc. Dr. Lloyd has become infatuated with her. Ironically, he dies a victim of scientific research after inoculating himself with an experimental serum that he hoped might be a successful vaccine.

View full annotation

The Doctor's Dilemma

Shaw, George Bernard

Last Updated: Jan-24-2000
Annotated by:
Coulehan, Jack

Primary Category: Literature / Plays

Genre: Play

Summary:

The story opens on the day that Ridgeon, a prominent research doctor, is knighted. His friends gather to congratulate him. The friends include Sir Patrick, a distinguished old physician; Walpole, an aggressive surgeon; Sir Ralph Bloomfield Bonington, a charismatic society doctor; and Blenkinsop, a threadbare but honest government doctor. Each one has his favorite theory of illness and method of cure. These are incompatible--one man's cure is another man's poison. Nonetheless, they all get along.

A young woman (Mrs. Dubechat) desperately seeks help for her husband from Ridgeon, who has evidently found a way to cure consumption by "stimulating the phagocytes." Ridgeon initially refuses, but changes his mind for two reasons--Dubechat is a fine artist and Ridgeon is smitten with his wife.

When the doctors meet Dubechat, however, they find that he is a dishonest scoundrel. Ridgeon eventually decides to treat Blenkinsop (who also has consumption) and refer the artist to Bloomfield Bonington, this insuring that he will die. In the end Ridgeon justifies his behavior as a plan to let Dubechat die before his wife find out what an amoral cad he actually was. This, in fact, happens and Dubechat's artistic reputation soars.

View full annotation