Showing 411 - 420 of 432 annotations tagged with the keyword "Professionalism"

A Small, Good Thing

Carver, Raymond

Last Updated: Jan-31-1997
Annotated by:
Aull, Felice

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

This story concerns the death of a child and failures of communication. Scotty, an eight year old, is hit by a car on his birthday. His mother had ordered a birthday cake but "there were no pleasantries between" her and the baker. Scotty is hospitalized, unconscious, and the cake is forgotten. Dr. Francis reassures the anxious parents that all will be well when the boy wakes up.

The baker phones the parents’ home in the dead of night (when he does his baking) because the cake hasn’t been picked up, but they can’t figure out who he is or what he wants. At the same time the doctors and staff can’t and won’t answer their questions about why Scotty isn’t waking up. Dr. Francis comes to the hospital to check the child, looking tanned, meticulously dressed, as if he has just been out for the evening- he has a life outside of the hospital, but the parents have none. When they do run home, separately, to take a break, the baker torments them with his mysterious late-night calls. Their confusion and isolation deepen. The child dies-"a one-in-a-million circumstance."

The mother finally realizes that it is the baker who has been calling and tracks him down, enraged. She unleashes all of the anger which she had been unable to express to the doctors. The baker is stunned to learn about the child’s death; he begs forgiveness and offers them warm delicious cinnamon rolls. "Eating is a small, good thing in a time like this" and they are comforted.

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The Good Doctor

Mates, Susan Onthank

Last Updated: Jan-31-1997
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Helen van Horne, the good doctor, has left her solitary practice as a physician in rural East Africa to become chief of the Department of Medicine at City Hospital. She is a tough, hard-as-nails woman who has given up the comforts of marriage, family, and human indiscretion for her profession. While the folks in South Bronx initially "hate" her because of her skin color, they soon learn that van Horne is a model of rectitude, dedication, and compassion. The Hispanic chief resident becomes her disciple.

Van Horne's yearning for human comfort and sexual gratification brings her into intimate contact with a lazy, irresponsible, but charming male student. Out of weakness, she tells the failing student that he will pass the rotation, but is later challenged by the chief resident, who has left her own lazy husband and dedicated herself to be "just like you." Van Horne realizes her own weakness, allows the failing grade to be recorded, then contemplates (but rejects) suicide.

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Laundry

Mates, Susan Onthank

Last Updated: Jan-31-1997
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

A physician stands in the laundry, folding her baby’s diapers, and thinks about Mr. Dantio, who died of wildly metastatic cancer. She reflects on the development of her relationship with Mr. Dantio during the time that she was pregnant. Toward the end, he developed a lung infiltrate, maybe a type of pneumonia. There was a chance that a biopsy might have helped--perhaps he had a treatable infection--but she recommended against it. Now she wonders about this decision. She wonders also about what the other physicians think of her: "you don’t really want to be a doctor anyway, you must be conflicted to have a child . . . . " She remembers seeing Mrs. Dantio in the supermarket shortly after her husband died, and crying with her. She asks herself: Will I ever be a REAL doctor, "because in moments of great stress I revert to my native tongue."

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Ambulance

Mates, Susan Onthank

Last Updated: Jan-31-1997
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

A medical student at Lincoln Hospital in the south Bronx is called to the Emergency Room, where a gang war is going on. She plunges through fighting bodies in the waiting room to reach the treatment area, where she is enlisted to ride an ambulance with a critically injured and intubated patient. During the trip, the ambulance jerks, the tube comes out, and the student tries but fails to ventilate him with mouth-to-mouth respiration. At the other hospital, she is turned away from the cafeteria because her clothes are blood-soaked. The patient dies. Although she feels terrible, her friend Marie, a practical nurse, comforts her with a touch of ordinary love, a photo of her new grandchild.

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The Good Doctor

Mates, Susan Onthank

Last Updated: Jan-31-1997
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Collection (Short Stories)

Summary:

Twelve contemporary stories set in Rhode Island and New York City. Major themes include the pain of cultural dislocation and cross-cultural experience ("Theng," "Shambalileh," "My German Problem"); human frailty and self-deception ("Sleep," "Juilliard"); and the personal and moral dimensions of medical practice. See the separate annotations for Laundry, The Good Doctor and Ambulance--three stories which are particularly relevant to Literature and Medicine.

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Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

Dr. Cassell examines the social and cultural forces that encourage the practice and teaching of a medicine that is governed by the disease theory. This theory discounts the impact of illness on the patient and ignores the suffering that the patient is experiencing. Cassell does not debunk science and technology, rather he encompasses them within the moral enterprise of medicine as tools for helping patients.

The ability to provide compassionate attention to the patient as individual (i.e., with unique values, life experiences, family interactions, etc.), trustworthiness and self-discipline are required characteristics of a "good physician." Cassell illustrates and personalizes the philosophical shift towards focusing on the sick person with stories and anecdotes.

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The Lost Art of Healing

Lown, Bernard

Last Updated: Jan-31-1997
Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

This autobiographical account of Dr. Lown's five decades of practice and research in cardiovascular medicine is both a history of the field and a history of a man passionately interested in people and healing. The book is divided into six sections: Hearing the Patient: The Art of Diagnosis; Healing the Patient: The Art of Doctoring; Healing the Patient: Science; Incurable Problems; The Rewards of Doctoring; and The Art of Being a Patient.

The first three sections comprise the bulk of the book: Lown chronicles his early medical training and career through stories of memorable patients, anecdotes about key role models (particularly Dr. Samuel A. Levine), and histories of medical mistakes, diagnostic acumen, and his remarkable research innovations. These achievements include the introduction of intravenous lidocaine, cardioversion and defibrillation, and development of the coronary care unit.

The core of the book, however, is about how deeply Lown cares for his patients. He states, “This book is a small recompense to my patients, ultimately my greatest teachers, who helped me to become a doctor.” The book contains many reflections on medical practice, such as this definition of medical wisdom: “It is the capacity to comprehend a clinical problem at its mooring, not in an organ, but in a human being.”

In a thoughtful chapter on death and dying, Lown muses on his emotional and spiritual responses to encounters with death, and bemoans the medical profession's increasing tendency to “put technology between us and our patients, to spare us the grief of failing to confront our own mortality.” In the final chapter, Lown takes an unusual twist, and writes a treatise to patients on how to get the doctor to truly pay attention to them and what are reasonable expectations to have of one's doctor.

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Hard Cash

Reade, Charles

Last Updated: Jan-29-1997
Annotated by:
Moore, Pamela

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Reade was known for writing "novels with a cause." Here, as in several other of his novels, his cause is the deplorable condition of mental hospitals in the early to mid-nineteenth century. Until late in the century, many considered the mentally ill untreatable. Hospitals were more like prisons than places for treatment. Admission policies were also fairly lax. Reade records a common fear that healthy people would be incarcerated.

In Hard Cash, a father incarcerates his son in order to cover up a crime. The doctors who admit him have a kickback scheme worked out with the hospital--they get money for each patient admitted. Once in the hospital, the hero tries to prove his sanity but finds it impossible to battle against doctors who refuse to look past the diagnosis that caused his admission to his actual mental condition. He also must negotiate with the head of the hospital, a woman who is madly in love with him and refuses to allow him out of her sight.

He cannot prove his sanity and only escapes when there is a fire in the asylum. There is one "good" doctor in the story who refuses to bleed patients, deny them food, or admit the sane to mental hospitals. The other doctors think him a quack, but he saves several lives.

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Summary:

This book offers an insightful, well-reasoned interpretation of the nature of medicine. Hunter, an English professor who teaches and coordinates humanities programs at a medical school, observed first-hand how an academic medical center functions--she joined various teams during their multiple rounds and conferences for two years. In sum, she "behaved rather like an ethnographer among a white-coated tribe." The resultant book details the profound importance of narrative in medicine.

Narrative is integral to the medical encounter, to communications by and about the patient, and to the structure and transmission of medical knowledge. For example, the patient's story is told to and interpreted by the physician, who then tells another story of the patient, in case format to other physicians, and records that story in a formulaic chart entry. Hunter observes that most of the rituals and traditions of medicine and medical training are narrative in structure, and explains why narratives such as cautionary tales, anecdotes, case reports and clinical-pathological conferences are central, not peripheral, to medicine. The thesis is further developed to maintain that, if the narrative structure of medicine is fully recognized by physicians, they will attend to their patients better and acknowledge the details and importance of their patients' individual life stories.

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Doctors and Other Casualties

Massad, Stewart

Last Updated: Jan-28-1997
Annotated by:
Wear, Delese

Primary Category: Literature / Fiction

Genre: Collection (Short Stories)

Summary:

This is a collection of short stories by a young physician, Stewart Massad, who completed a residency in obstetrics and gynecology and a fellowship in gynecologic cancer. The stories are all written in the first person, all physicians. The subjects include the physical/emotional demands of residency ("Fatigue"), especially as they strain a marriage; the motivations of a doctor who runs an abortion clinic ("Healers"); and a young doctor facing his own fatal illness and his experience as a patient ("Casualties"). While the stories do portray the difficulties (and often angst) of training, they do so without the despair/cynicism often found in other accounts of the same experience.

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