Showing 41 - 50 of 80 annotations in the genre "Essay"
The author, Samuel Shem, opens these reflections by saying that he was a writer before he was a doctor. His early answers to questions about healing came from stories he read. "Life as it should be in addition to life as it is" became the "motor" of his writing. He loved stories that he heard from patients and the "few humane doctors" he met and decided he would be able to understand people better by writing about experiences with them.
Shem's experience as an intern spawned The House of God (see this database) and he sees writing about his training as an example of the use of resistance when he saw "something unjust, cruel, militaristic or simply not right." He recommends the following to resist the inhumanities in medicine: (1) Learn our trade in the world, (2) Beware of isolation, (3) Speak up, (4) Resist self-centeredness. He says that the healing essence of narrative is in "we," meaning the patient and the physician.
St. Luke’s Hospital was founded in 1750 to provide free care to the impoverished mentally ill. It mixed benevolence with "unconscious cruelty" in the treatments used by the "practitioners of old," from restraints and drugs to swings and a key to force-feed recalcitrant patients. Dickens describes this gloomy edifice as he saw it on December 26, 1851, although he notes a "seasonable garniture" of holly.
The inhabitants of St. Luke’s largely sit in solitude. Dickens decries the absence of "domestic articles to occupy . . . the mind" in one gallery holding several silent, melancholy women, and praises the comfortable furnishings--and the relative "earnestness and diligence" of the inmates--in another. He uses statistics to show the prevalence of female patients, "the general efficacy of the treatment" at St. Luke’s, and the unhealthy weight gain of the inhabitants due to inactivity. Dickens describes the behavior of various distinctive inhabitants during the usual fortnightly dance, the viewing of a Christmas tree, and the distribution of presents.
Another Dimension is an occasional feature of the journal, Emerging Infectious Diseases, published by The Centers for Disease Control and Prevention (CDC). These essays (and occasionally poems or stories) focus on human and philosophical issues related to medical practice, scientific research, and public health. The intention of this feature is to bring a new perspective to the journal’s coverage of medical science and public health. Some of the essays include a painting or other image that draws attention to the subject matter of the essay.
Managing editor, Polyxeni Potter, with the encouragement of Joseph E. McDade, founding editor of the journal, initiated and is guiding this feature (see also the annotation of Potter: Emerging Infectious Diseases cover art). Since this is a government site, its material is freely available on-line.
In this chapter (no. 43) from his autobiography, Williams seeks to describe the poetry of medicine, the almost indescribable quality (Williams frequently refers to it as "it" and "the thing") that draws him to his practice. Clearly it is not anything medical-technical. He particularly disparages surgery and the idea that you can cure by merely cutting. Rather, it involves seeing each patient as "material for a work of art"(287), by which he seems to mean a natural showing of strong character or selfhood under pressure of difficulty. In a strong central passage Williams calls medicine "the thing which gained me entrance to these secret gardens of the self"(288).
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.
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.
Summary:The author provides a historical review of physicians who became famous practicing a profession other than medicine. Most of the article focuses on physician-writers, beginning with Francois Rabelais, and including both well-known and obscure figures. There are extensive comments on Louis-Ferdinand Celine, Gottfried Benn, Friedrich Wolf, Mikhail Bulgakov, Oliver Goldsmith, Anton P. Chekhov, Arthur Schnitzler, W. (William) Somerset Maugham, Sir Arthur Conan Doyle, Oliver Wendell Holmes, William Carlos Williams, among others. The most complete discussion (5 pages) is devoted to Sir Arthur Conan Doyle.
At the age of 37, artist/photographer (and former model), Matuschka, was diagnosed with breast cancer. While her most famous response to the disease was her startling photograph on the cover of The New York Times Magazine revealing the results of mastectomy, her political activism surrounding breast cancer took many forms. (The photograph can be viewed at a Web site, Matuschka Archives )
Not only did she have a disease to confront, she felt she had the responsibility to "take on the establishment." She wrote, "My extensive research and understanding of how cancer works and how breast cancer therapies don’t--in addition to my medical nightmare with my doctor (I was first underdiagnosed, then overtreated)--I felt I had other messages to convey."
Thus, her essay describes her ongoing project: not hiding or concealing the condition, but becoming sexy and strong as a result; and reaching middle America with her images to promote breast cancer awareness, education, treatment, and prevention. Artistically and politically, she was determined to project images of women after surgery as whole people with a scar, not the decapitated torsos of medical illustration and other media that give "too much weight to the ’deformity’ that accompanies breast cancer surgery."
The essay chronicles the difficulties she had in finding sites for publication of her work, including her photo/biography, Beauty Out of Damage, and the continuing harsh criticism that she receives, much of it from "mastectomy women." In turn, she continues her harsh criticism against what she calls "backlash in the breast cancer movement," such as mixing political action with consumerism (e.g. Ralph Lauren’s "Target Breast Cancer" t-shirts that put targets on women), or mixing modeling with breast cancer activism (Cindy Crawford modeling the t-shirt rather than women who have had breast cancer modeling the shirt), among many other examples.
Her closing lines summarize the intent of her activism: "to inspire others to become involved in revolutionizing the medical profession, particularly in regard to women’s cancers. After seeing the film of my mastectomy operation, my only reply was, ’No one should ever have to go through this.’"
The author, an internist and medical educator with a long-term interest in literature (she recently was awarded a Ph.D. in English literature), describes the literary exercise she uses to develop empathy in students taking her required course in medical interviewing. Charon has her students choose a difficult medical encounter from their own recent training and then write, using the first person, the story of that patient’s life in the day before the difficulty--including being treated by the medical student who is doing the writing. Because much of the story must be imagined, the writer’s intuition is automatically brought into play.
Because it is told from the patient’s point of view, the medical student is forced to see the patient whole and without reference to medical terms. Charon argues that this exercise of the imagination yields a combination of objectivity and empathy that forms the basis for good medical care. She also finds that the exercise helps medical students see themselves as their patients see them--and thus to understand, for instance, the effect on their patients of their youth and nervousness.