Showing 391 - 400 of 565 annotations tagged with the keyword "Physician Experience"
Summary:Hilfiker describes a number of his own medical errors. He is concerned with the physical, emotional, social, and economic consequences of medical mistakes, all of which have grown as medicine's ability to cure disease has grown. Hilfiker contends that physicians are poorly equipped to cope with their own mistakes. The nature and practice of medicine are such that it is often possible to conceal mistakes from patients. Should they be concealed? Hilfiker says not. He implies that there are few (if any) circumstances which warrant deception.
Summary:This short autobiographical account gives a flavor of American medical practice in the early part of the 20th century. It also sketches the medical "persona" and the human character of the author's father.
A physician is summoned to make a housecall on a family with whom he has had no prior contact. He quickly sizes up the situation: the household is poor but clean; the patient is a female child whose parents are nervously concerned, dependent on, yet distrustful of the doctor. The child's beauty and penetrating stare make an immediate impression on him.
Concerned that diphtheria may be the cause of illness, he uses his customary professional manner to determine whether or not the child has a sore throat. But the child will have none of it and "clawed instinctively for my eyes." The attempt at an examination rapidly escalates into a physical "battle" as the physician, convinced that it is crucial to see the child's throat "and feeling that I must get a diagnosis now or never," becomes ever more enraged and forceful while the girl continues to resist with all her strength, and the parents are in an agony of fear for her health and embarrassment over her behavior.
This is no longer a professional encounter. The doctor admits at the beginning of the struggle to having "fallen in love with the savage brat" and recognizes that he is behaving irrationally. The closing sequence could as easily be depicting a rape as a forced throat examination.
Summary:A physician recounts an experience he had assisting an American plastic surgeon as he performed charity surgery in Honduras. One young woman, Imelda, dies of malignant hyperthermia prior to surgical repair of her cleft lip. After her death, the surgeon returns to the patient to finish the surgery. The narrator tries to imagine the surgeon's motivation for this act, as well as the family's reaction to it.
Summary:A third year medical student rotates through a gynecology clinic at the university. The attending Dr. Snarr, is supposed to treat his patients' chronic pelvic pain, but only seems to inflict pain himself. The student/narrator wants to comfort the patients, but lacks the knowledge, skills, and authority. The student also feels uncomfortable with issues of sexuality and intimacy with these female patients.
The narrator recounts the interview with his physician during which he learned the bad news about his lung cancer--although the word "cancer" is never mentioned. But the interview is marked throughout by signs of imperfect communication. At several points, the physician's grave remarks are matched by diffident, sometimes humorous responses.
For example, when asked if he is a religious man or a communer with nature, the narrator responds "I said not yet but I intend to start today." The culminating account of miscommunication is near the end: "he said something else / I didn't catch and not knowing what else to do / and not wanting him to have to repeat it / and me to have to fully digest it / I just looked at him." The final line clinches the oddly blurred nature of the whole exchange: "I may even have thanked him habit being so strong."
In this chapter from late in his autobiography Williams focuses on his subjective experience in caring for patients. The unusual truthfulness of patients in need, their "coming to grips with the intimate conditions of their lives," inspires him both personally and artistically, as a poet. The things that patients reveal about themselves and about the human condition not only keep him going as a physician; they are the stuff of poetry, the human truths that lie beneath the "dialectical clouds" we construct to protect ourselves from contact in everyday life.
In The Mysteries Within, Sherwin Nuland takes the reader on a guided tour of selected organs inside the human body. Beginning with the stomach, he progresses along to visit the liver, spleen, heart, uterus, and ovaries. At each point he addresses various historical and contemporary beliefs, as promised in the book's subtitle, "A Surgeon Reflects on Medical Myths." Nuland brings to this endeavor the patented mixture of personal story, elucidation of medical history, and plain old good writing that characterizes all of his books.
For example, he devotes the first three chapters to the stomach. The first consists mostly of a brilliant clinical tale in which a six-week-old baby is found to have a wax bezoar in his stomach. The second and third provide a cogent survey of beliefs about the stomach's function, beginning with Greek humoral theory, continuing through van Helmont and the iatrochemists, and ending with Ivan Petrovich Pavlov and his seminal monograph, The Work of the Digestive Glands.
Van Helmont and his mentor, Paracelsus, appear again and again in later chapters as the earliest champions of the idea that the body runs by means of chemical processes (iatrochemistry). However, as Nuland points out, Paracelsus has left us two different legacies. One is his devotion to chemistry and experimentation, which eventually led to modern biological science. The other is his devotion to alchemy and mysticism, which makes him as well a forerunner of contemporary irrational systems of healing.
Fridolin, a doctor, and his wife, Albertine, have been married for a few years and are the parents of a much adored little girl. In a moment of unusual frankness, they decide to confess all their temptations and adventures to one another. Albertine admits that she deeply desired a blond Dane encountered in the previous summer. Fridolin professes to welcome this news and tells of similar attractions. They promise to confide the sexual adventures of their waking and dreaming states.
But Fridolin is not at ease. The idea that his wife desired another-even in a dream-inspires a jealous energy that sends him in search of adventures that will reassure him of his own desirability and hurt if not repudiate Albertine. On the pretext of a house call, he wanders, masked and unmasked, through the decadent private clubs and cafés of night-time Vienna. He toys with the dismal daughter of a patient, an "unspoiled" prostitute, and a sophisticated matron--none of whom he actually claims, all of whom remind him of his wife, one of whom dies, he believes, in protecting him.
Uncertain if his adventure was reality or dream, he returns with tenderness to Albertine, although he has repeatedly vowed to leave her. He tells his entire story; she listens with better grace than he would have done. Then he asks what they should do. She replies that they should be grateful to have "emerged safely from these adventures" . . . "neither the reality of a single night nor even of a person's entire life can be equated with the full truth about his innermost being." "And no dream," he responds "is altogether a dream." (p. 98-9). They begin another day.
The Physician in Literature is an anthology edited and introduced by Norman Cousins that aims to illustrate the multiple ways in which doctors are portrayed in world literature. Literary selections are organized into 12 categories including Research and Serendipity, The Role of the Physician, Gods and Demons, Quacks and Clowns, Clinical Descriptions in Literature, Doctors and Students, The Practice, Women and Healing, Madness, Dying, The Patient, and An Enduring Tradition.
Some of the notable authors represented in this collection include Leo Tolstoy, Herman Melville, Albert Camus, William Shakespeare, Charles Dickens, George Bernard Shaw, Anton P. Chekhov, Orwell, Fyodor Mikhailovich Dostoevski, Ernest Hemingway, Thomas Mann, Gustave Flaubert, and Sir Arthur Conan Doyle. A healthy dose of William Carlos Williams makes for some of the most enjoyable reading ("The Use of Force" and excerpts from his Autobiography).