Showing 391 - 400 of 484 annotations tagged with the keyword "Art of Medicine"
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.
Corky Nixon is a patient in a ward of amputees in a military hospital for casualties of the Korean War. He has lost both legs. The head nurse on the ward has been given the nickname "Old Ironpuss" because she is so fierce and strict and unattractive, showing, as Corky says, "no warmth, no sympathy, no concern" (131). By implication, she is unfeminine. All the patients fear and hate her.
On Christmas Eve, a severely injured patient, Hancock, is brought in. He is conscious but catatonic. Corky is outraged that "Old Ironpuss" should be taking care of Hancock (he says that so sick a patient should get "the best damn-looking nurse in Christendom"!). Corky tries to get Hancock to talk, but is interrupted when the nurse comes in and berates Hancock for being such a difficult patient. Corky is outraged and complains to the colonel, who then points out that Hancock, reacting to the nurse's diatribe, has roused himself, talked back, and begun to recover.
He tells Corky that in cases like this, kindness and sympathy don't work and that the best treatment is the provocation of anger. Corky accepts this, and decides to collaborate with the nurse by having all the men in the ward stage the loud singing of Christmas carols with bawdy new lyrics, ostensibly to irritate her. In the midst of this chaotic display of good spirits, we see "Old Ironpuss" listening to their spirited defiance, and then turn away, alone, weeping.
Summary:Dividing the background expanse of red from yellow, and surrounded by a halo, three apples--green, red, and purple, four yellow papyrus blossoms, and a snake held between the fingers of the artist's hand, a disembodied head appears caricature-like in this self-portrait.
In this extensive review of her experiences in public health and rural and urban medicine, Eva Salber, MD, explores the commonalities and the differences in medical practice among three environments: pre-World War II South Africa, urban America, and the hills of North Carolina. Trained in South Africa, where she and her husband practiced for many years, Salber came to the US during a very difficult political period for whites in Cape Town.
In Boston, she pursued her passion for the plight of the poor and their health issues by studying further public health and running a ghetto clinic. Later, as a member of the Duke University faculty, she established rural health clinics in North Carolina. She describes, in this memoir, the contrasts among the cultures as well as her own difficulty in obtaining the funding and support she needed to carry out her work in each setting.
The writer describes her experience as a cancer patient, thrust into "the Land of the Sick" by the diagnosis and treatment of lung cancer four years earlier. Although she is not ill, the fear of mortality embedded in a diagnosis of cancer is a dragon that haunts her existence.
To cope with the dragon she relies on talismen: her doctors, personal will, and her garden peas, an emblem of everyday life and its constant renewal. The talismen create the semblance of control over her situation. She observes that "doctors and patients are accomplices in staging a kind of drama" and that the patient and her continued well-being become talismen for the doctor too.
This is a collection of medically related stories and poetry, most of which were previously published in medical journals like JAMA (Journal of the American Medical Association), Annals of Internal Medicine, and the American Journal of Medicine. "Country Doctors of Humble Pie," "Boss Cow," and "Discipline" are humorous tales about small town medical practice. "Second Opinions," "Net Worth," and "Making Friends" are stories of patients and their idiosyncrasies.
"Hafiz Ali Goes Home" concerns a dying man who wishes to return to his home village to die, rather than dying in the sterile confines of the hospital. The story details the misadventures of Hafiz Ali's two sons as they attempt to carry out his last request.
Many of the poems deal with clinical diagnoses ("Zoster" and "Lupus Erythematosis") or the history of medicine ("Towne of Guy's" and "The Turning"). "Doing Post-Mortems" is a thoughtful poem about the war (or relationship?) between the sexes in medicine.
A two-year-old girl is brought to the Emergency Room. Her father believes there's nothing wrong with her, but the mother says that earlier the child had looked "blank," and is sure there's a problem. The physician tries to work out what might be wrong.
The child seems fine, but he automatically looks for signs of abuse, and the triage nurse suggests the parents, who are African-American and on Medicaid, are there because they want "something for free" (127). There are other patients waiting, the child's vital signs are fine, the father wants to leave.
As the doctor is leaving the examining room, he asks whether she might have taken someone's medication, and the mother mentions that the child's grandmother takes "sugar pills," hypoglycemics. They test the child's blood sugar and it is dangerously low. She is admitted to the hospital.
The physician tells the mother she has saved her child's life, and then considers how lucky they had all been--"I felt sick, cold, and damp, terrified by what I had almost missed" (131). He says that since then, he often thinks of the child, "alive in the world, going out into it, . . . decade after decade ahead."
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.
This is a collection of partly fictional, partly autobiographical stories about a young Russian doctor sent to practice at a rural hospital immediately after graduating from medical school. Muryovo hospital serves the peasantry in a remote region lacking decent roads and amenities like electricity. The doctor works day and night, aided by a feldsher and two midwives. Sometimes he sees over 100 patients a day in his clinic while attending to another 40 in the hospital.
The stories reveal in a clear, engaging style the doctor's anxiety as daily he encounters new problems (his first amputation, his first breech presentation, his first dental extraction) and-- for the most part--overcomes them. They also reveal a constant tension between the peasants' ignorance and the doctor's instructions. Full of blizzards and isolation, the stories are also warm and companionable, with vignettes of friendship, gratitude, and nobility.
Summary:The wife of an anthropologist can not bring herself to confess to her husband that she had all her upper teeth removed many years before when he was away for an extended period. When she is hospitalized for a hysterectomy, she is told she must remove her dentures. She is appalled that her husband might see her without her teeth and nearly refuses the operation. She is helped by an Indian physician with a limp who understands her needs.