Showing 401 - 410 of 558 annotations tagged with the keyword "Physician Experience"

To Render the Lives of Patients

Charon, Rita

Last Updated: Nov-16-2001
Annotated by:
Woodcock, John

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

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.

View full annotation

Annotated by:
Shafer, Audrey

Summary:

Levin, a social documentary photographer, immersed herself with the Class of 2001 in the anatomy course at Weill Medical College of Cornell University. Her photographs of cadavers, students and instructors are prefaced by a foreword by physician-writer Abraham Verghese. He describes the rite of passage of anatomical dissection: "The living studying the dead. The dead instructing the living." (p. 9)

Interspersed with the full-color images are journal entries by 11 medical students and several artistic anatomic illustrations by 3 of the students. The journal entries and photographs are organized temporally, from the introduction to the dissection lab to the final exam and student-organized memorial service. The end of the book includes the interests and brief biographies of the 11 students and a final dedication by Levin of the book to those who donated their bodies: "I have never before witnessed a gift that is honored, respected, and consumed so completely."

The photographs are not for the squeamish. For example, the double amputee pelvis prosection on page 102, or the multiple images of flayed skin, bits and pieces, or limbs tied to supports provide an insider's view of an anatomy course. Many of the images show the living in motion: translucent images of students in time-lapse swirl near the static cadavers. Other images conjure the once-upon-a-time personhood of the dead: pink fingernail polish on a female cadaver or a heart palmed by a student. The intensity of the student experience is well documented, as is the relaxed atmosphere that inevitably develops as students become accustomed to the experience of dissection.

The student journal entries are sensitive and thoughtful. Students comment on the intersections of daily living, home life, and their own bodies and bodily functions with what they are learning in the classroom. Particular discomfort regarding certain dissections, such as the pelvic region, are acknowledged. Even though students note growing immunity to the dissection experience, such comments reflect insight into professionalism and defense systems. Gallows humor and uneasiness with such humor is explored by Rebecca (p 62) after she sings "New York, New York" to the roomful of cadavers. Forensic clues about the cause of death for a particular cadaver renew the sense for students that this was once a living, feeling person.

The intense, long hours required for understanding and memorizing the material are clearly evident, but ultimately, these students realize they are given a truly special opportunity: "I began to love learning the material just for the sake of learning. Anatomy no longer felt like a burden, but rather a gift." (David, p. 119) Relationships explored include those of student with cadaver (particularly respect/disrespect, ownership and protection), life with death, and those who have had the experience of dissection with those who never will.

View full annotation

Annotated by:
Shafer, Audrey

Primary Category: Visual Arts / Photography

Genre: Photography

Summary:

Levin, a social documentary photographer, immersed herself with the Class of 2001 in the anatomy course at Weill Medical College of Cornell University. Her photographs of cadavers, students and instructors are prefaced by a foreword by physician-writer Abraham Verghese. He describes the rite of passage of anatomical dissection: "The living studying the dead. The dead instructing the living." (p. 9)

Interspersed with the full-color images are journal entries by 11 medical students and several artistic anatomic illustrations by 3 of the students. The journal entries and photographs are organized temporally, from the introduction to the dissection lab to the final exam and student-organized memorial service. The end of the book includes the interests and brief biographies of the 11 students and a final dedication by Levin of the book to those who donated their bodies: "I have never before witnessed a gift that is honored, respected, and consumed so completely."

The photographs are not for the squeamish. For example, the double amputee pelvis prosection on page 102, or the multiple images of flayed skin, bits and pieces, or limbs tied to supports provide an insider’s view of an anatomy course. Many of the images show the living in motion: translucent images of students in time-lapse swirl near the static cadavers. Other images conjure the once-upon-a-time personhood of the dead: pink fingernail polish on a female cadaver or a heart palmed by a student. The intensity of the student experience is well documented, as is the relaxed atmosphere that inevitably develops as students become accustomed to the experience of dissection.

The student journal entries are sensitive and thoughtful. Students comment on the intersections of daily living, home life, and their own bodies and bodily functions with what they are learning in the classroom. Particular discomfort regarding certain dissections, such as the pelvic region, are acknowledged. Even though students note growing immunity to the dissection experience, such comments reflect insight into professionalism and defense systems. Gallows humor and uneasiness with such humor is explored by Rebecca (p 62) after she sings "New York, New York" to the roomful of cadavers. Forensic clues about the cause of death for a particular cadaver renew the sense for students that this was once a living, feeling person.

The intense, long hours required for understanding and memorizing the material are clearly evident, but ultimately, these students realize they are given a truly special opportunity: "I began to love learning the material just for the sake of learning. Anatomy no longer felt like a burden, but rather a gift." (David, p. 119) Relationships explored include those of student with cadaver (particularly respect/disrespect, ownership and protection), life with death, and those who have had the experience of dissection with those who never will.

View full annotation

Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Collection (Case Studies)

Summary:

Crossing Over presents "extended, richly detailed, multiperspectival case narratives" of 20 dying patients served by the Hospice of Lancaster County in Pennsylvania and the Palliative Care Service of Royal Victoria Hospital in Montreal. These complex narratives (each written by a single author) reveal the patient’s story from many points of view, including those of family members and professional caregivers.

The authors explain how this project differs from recent books of clinical narratives by Timothy Quill (A Midwife Through the Dying Process, 1996), Ira Byock (Dying Well: The Prospect of Growth at the End of Life, 1997), and Michael Kearney (Mortally Wounded. Stories of Soul Pain, Death and Healing, 1996 [see entry in this database]). Barnard et al. point out that Quill, Byock, and Kearney are "passionate advocates for their own styles of care . . . Yet these very characteristics--advocacy and close personal involvement--limit their books in important respects." (p. 5) Basically, these authors select cases that illustrate the efficacy of their models and present the patients’ stories from their own point of view.

Crossing Over draws on a standard qualitative methodology that includes tape-recorded interviews of patients, families, and health care professionals; chart reviews; and participant observation. After the introduction, the narratives occupy 374 pages of text (almost 19 pages per patient). Part II of the book, entitled "Working with the Narratives," includes a short chapter on research methods and 29 pages of "Authors’ Comments and Questions for Discussion." The latter is designed to be used as a teaching guide.

View full annotation

Chekhov's Sister

Wetherell, W. D.

Last Updated: Nov-01-2001
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Anton Chekhov died in 1904. His sister Marya (or "Maria" in this novel) survived the Communist Revolution and two World Wars to die in 1957 at the age of 94. After Anton's death, the unmarried Maria assumed his role as head of the extended Chekhov clan and she devoted the remainder of her life to the protection and advancement of her brother's literary legacy. To do so, she had to plead his case with the Russian authorities and later adapt to the political (and literary) orthodoxy imposed by the Communist regime. Early in the Soviet era, Maria successfully lobbied to have the Chekhov house at Yalta turned into a State museum, thereby insuring that the author's books and papers would be preserved.

The action of this novel takes place during the Great Patriotic War in late 1941 when the Germans occupied Yalta. Maria lives at the Chekhov museum, where she presides as curator. Also living at the house is Peter Kunin, a medical student and would-be writer who is Maria's protégé. In preparation for the Germans' arrival, Maria arranges the house to make it seem that Chekhov was pro-German. For example, she has Kunin dig up an old portrait of Goethe to hang over the mantelpiece.

Despite these machinations, the Germans fully intend to billet soldiers in the museum until a mysterious man named Diskau shows up. Diskau, who works for the German Ministry of Culture, insists that the Chekhov household be spared. In fact, he proposes to win over the local population to the German "liberators" by staging a New Year's Eve production of The Seagull in the abandoned Imperial Theater.

The remainder of the novel traces preparations and rehearsals, culminating in the single catastrophic performance of The Seagull, during which all is revealed.

View full annotation

Poems in Our Absence

Andersson, Claes

Last Updated: Nov-01-2001
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

This is the first "selected poems" by Claes Andersson to appear in English. Drawn from his 18 collections published in Finland, they are generally short (less than one page) poems without titles. As the Introduction notes, Andersson's early poetry features blunt language, while his later work strives for more musicality. Drawing on his psychiatric experience, Anderson uses "private life as a foundation for an investigation of all that shapes our identity."

Friendship is a frequent theme in these poems, as in "Philemon and Baukis": "If you become a fir / I'll be a birch/ Thus you protect and warm me / through the cold seasons / In return I'll dance for you / in the summer nights . . . " (p. 75) One of the most striking poems in the collection is "the new theology," which begins: "Disease is the conscience of the body / What would we be without our ailments . . . " (p. 112)

View full annotation

Pilgrim

Findley, Timothy

Last Updated: Sep-18-2001
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction — Secondary Category: Literature / Fiction

Genre: Novel

Summary:

The novel opens with a man known only as Pilgrim hanging himself in London in 1912. Despite being pronounced dead by two physicians, he somehow lives. Pilgrim has attempted suicide many times before but is seemingly unable to die. He claims to have endured life for thousands of years but has tired of living and only longs for death. He has crossed paths with many historical figures including Leonardo da Vinci, Saint Teresa, Oscar Wilde, and Auguste Rodin.

After his most recent suicide attempt, he is admitted to a psychiatric facility in Zurich as a patient of the famous Swiss psychiatrist, Carl Jung. Pilgrim eventually escapes from the institution and masterminds the successful theft of the Mona Lisa from the Louvre. Next, he sets the cathedral at Chartres on fire. The novel ends with Pilgrim driving a car into a river on the eve of World War I. His body is never found.

View full annotation

Annotated by:
Woodcock, John

Primary Category: Literature / Nonfiction — Secondary Category: Literature / Nonfiction — Secondary Category: Literature / Nonfiction — Secondary Category: Literature / Nonfiction

Genre: Essay

Summary:

Seeking redemption in the bloody business of surgery, Selzer's narrator tells several medical stories that humbled his surgeon's pride and refers approvingly to an atheist priest in a story by Unamuno who carried on for the sake of his congregation because "their need is greater than his sacrifice." Selzer finally tells us that it is in writing, if anywhere, that the elusive soul can be represented.

View full annotation

Annotated by:
Miksanek, Tony

Primary Category: Literature / Nonfiction — Secondary Category: Literature / Nonfiction — Secondary Category: Literature / Nonfiction — Secondary Category: Literature / Nonfiction

Genre: Essay

Summary:

The Exact Location of the Soul is a collection of 26 essays along with an introduction titled "The Making of a Doctor/Writer." Most of these essays are reprinted from Selzer's earlier books (especially Mortal Lessons and Letters to a Young Doctor). Six pieces are new and include a commentary on the problem of AIDS in Haiti ("A Mask on the Face of Death"), musings on organ donation ("Brain Death: A Hesitation"), a conversation between a mother and son ("Of Nazareth and New Haven"), and the suicide of a college student ("Phantom Vision").

View full annotation

Annotated by:
Kohn, Martin

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

A physician seeks solace at the South Pole. Her planned one year stay there is cut short when she discovers a lump in her breast. The attempts to care for her at the South Pole (with telecommunicated help from the U.S.) prove insufficient and a plan to rescue her is successful.

There's more than the drama of illness in a remote location in this book, however. Intertwined with this story of illness is the story of the author's troubled marriage (to her physician-husband), the eventual estrangement from her children, the support of her family of origin, and most fascinatingly the daily rhythms of living (and doctoring) at the South Pole. Scattered throughout the memoir are occasional critiques of "corporate" medicine and poems that inspired the author throughout her ordeal.

View full annotation