Showing 381 - 390 of 476 annotations tagged with the keyword "Medical Ethics"
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.
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.
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.
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.
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.
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.
Jacob Hansen is sheriff, undertaker, and pastor in the little Wisconsin town of friendship. A Civil War veteran like many of the men in his town, he has seen many faces of death and knows how to balance compassion, prayer, and practicality in the presence of grief. When he recognizes a diphtheria epidemic as one after another the people of Friendship fall ill and die, he has to shoulder responsibility for protecting public health.
This means imposing and enforcing quarantine, extending even to the encampment of religious revivalists at the edge of town who mostly keep their distance and their own ways. Jacob's equanimity falters when his wife and baby daughter succumb; he keeps them alive in his mind and unburied for days, unable to acknowledge his own loss, though he helps others through theirs.
Finally he forces a passing railroad engineer to transport the survivors across the quarantine border into a neighboring town for safety, but the train is sabotaged, wrecked, and the fugitives killed. Jacob survives almost alone to return to what is now a ghost town and cope with the grim fate of survival.
A medical instrument kit from the year 2450 is transported back in time and falls into the possession of old Dr. Full, a retired physician and drunkard who had been expelled from the medical association for milking patients. The futuristic instruments are awe-inspiring and virtually operate themselves. The discovery of the black bag restores Dr. Full's self-worth and dedication to healing.
A street-wise woman, Angie, realizes the value of the medical instruments and their origin. She forces Dr. Full to accept her as a partner. The two of them soon establish a successful medical practice. When Dr. Full decides to donate the instrument kit to the College of Surgeons, Angie murders him.
While demonstrating the safety of the medical bag to a patient, Angie plunges the futuristic surgical scalpel into her own neck, confident it will do no harm. Meanwhile, authorities in the future learn that the medical bag is missing and deactivate it just prior to Angie's demonstration. She slits her own throat. By the time the police arrive, the contents of the black bag had already rusted and are decomposing.
Carl Elliott and John Lantos have brought together a collection of 12 essays that explore the complex work and person of Walker Percy. Personal reflections and stories capture the importance of Walker Percy in the lives and work of several of the essayists, while others offer commentaries on various aspects of Percy's life and work. All of the contributors reveal their affection and appreciation of Walker Percy as physician, novelist, and philosopher.
In addition to the editors, the contributors include Robert Coles, who was Percy's friend; Ross McElwee, the documentary filmmaker; Jay Tolson, Percy's biographer; author and historian Bertram Wyatt-Brown; scholars Martha Montello and Laurie Zoloth; and physicians Brock Eide, Richard Martinez, and David Schiedermayer.
The collection covers many topics and themes. Percy's biography is reviewed: the early losses of his father and grandfather by suicide, the early death of his mother, his medical education and subsequent struggle with tuberculosis, his turn from medicine to philosophy and literature, his marriage and conversion to Catholicism, and his long and productive life as a philosophic novelist.
The essays explore Percy as both physician and patient, and how, as diagnostic novelist, he gives us characters and stories that caution about the technologic-scientific worldview that dominates not only medicine but western life. The many wayfarers are discussed, including Binx Bolling from The Moviegoer, Will Barrett from The Last Gentleman, and Dr. Tom Moore from Love in the Ruins and The Thanatos Syndrome. [These novels have been annotated in this database.]
Percy's spiritual and religious views are reviewed, along with his moral concerns about a post-modern world before anyone had coined the term. The problems of isolation, alienation, and struggle for meaning are apparent in all of his works, and many of the essayists explore the connection between his novels and these existential concerns. The importance of Kierkegaard in his work, his theory of language, and his early essays are discussed.
The contributors give examples of how Walker Percy's life and work are incorporated in medical education and the practice of medicine, both in personal and theoretical terms. Percy's work reminds practitioners of the necessity for human connection in the midst of scientific and technologic paradigms that distance practitioner from patient. Likewise, medicine and medical education shaped Percy the novelist, where keen observation and sustained searching for answers are to be found in all of his fiction.
A feminist critique of Percy's development of women characters, reflections on physician characters in Percy's work, his personal struggle with a family history of depression, and his attitudes about psychiatry and psychoanalysis complete the collection.
The poet expresses pity for all the poor, poor animals--for dogs, for mice, for earthworms, even for the "protozoons / that sway their cilia / so desperately." On the other hand, "patients / with progressive amyotrophic lateral sclerosis can just / fuck off." They should go live in the world of Hieronymus Bosch. [21 lines]