Showing 491 - 500 of 573 annotations tagged with the keyword "Physician Experience"
The narrator of this long, lyrical musing is a psychiatrist who works with autistic children. Though much of the narrative is a reflection on her mid-life relationship with a journalist lover who risks death to report on places in political turmoil, her observations about her patients provide a recurrent motif and reference point.
Several long passages detail the fascination and frustration involved in working with her young patients, what she has learned from them about limits, patience, and the semiotics of autism. She also reflects on how that learning has allowed her to understand "normal" people differently. One of the subtle but strong themes of the story is the question of what "normal" means.
A secondary focus is her close attachment to her two grown sons. This is developed through memories of particular scenes of their childhood that she identifies as bonding moments. Another focus is her relationship with her mother, now dwindling into mental incompetence and squalor in her old age. Thinking about these relationships, with lover, sons, mother and patients, is a way of taking stock of how the strands of her life have brought her to a place of qualified peace in mid-life.
Dr Bernard Rieux (William Hurt) says good-bye to his ailing wife at the Oran airport in South America. Their only child is dead. She has gone to the distant capital for tests and he plans to join her in a few days. But a mysterious epidemic of rats and what turns out to be bubonic plague breaks out. The city is sealed by draconian authorities who separate family members and drag people from their homes. Rieux decides to stay; months pass and his wife will die before he can see her again.
He befriends two stranded French journalists, Martine (Sandrine Bonnaire) and Tanto (Jean-Marc Harr), who volunteer as aides. They visit Joseph Grand (Robert Duvall) who keeps the cemetery statistics and writes an interminable novel. Tanto and Grand contract the disease but manage to survive under Rieux's care.
Constantly palpating her body in fear, Martine is desperate to flee, even as she strives to evoke passion from the emotionally numb Rieux. She is robbed and incarcerated by Cottard (Raul Julia) an unscrupulous profiteer. As the epidemic wanes, the journalists, the doctor, and Grand are reunited, but in that same instant Cottard shoots Tanto dead. Rieux and Martine are left sobbing in each others arms.
A woman medical student finds herself in a hierarchical dilemma while rotating through her internal medicine clerkship. She is helping to take care of a middle-aged man who has been hospitalized for a diagnostic work-up. As a consequence of invasive procedures ordered by his physicians to determine the cause of his symptoms, the patient has suffered serious complications and is moribund. The doctors are evasive with the patient and his family, who beseech the medical student for an explanation. Even though she has been instructed by the physicians to refer all issues back to them, she follows her own convictions and tells the truth: "Your father is dying."
As a result of this "insubordination," she is called in to see the head of the department, a man of "legendary diagnostic skill" with a long tenure at the hospital. He says that he will have her dismissed, and launches into a long diatribe, making the case for a paternalistic medicine in which the patient needs to believe that the physician is omniscient and possesses quasi-magical healing powers. "Miracle, mystery, and authority," he says, are at the heart of what physicians can do for their patients and to undermine these is to do harm to the vast majority of the sick. Having made his point, he terminates the interview but reinstates the student, who, it is suggested, is so grateful (for his advice or for not being dismissed?) that she kisses him.
This is a collection of stories and sketches by a practicing neurologist. Most of the material is clinical and autobiographical. In "Mrs. Bachman" a new patient enters the doctor's office, carrying a thick stack of medical records. It all started in 1946 and no doctor has ever found the explanation of her condition. Meanwhile, the doctor is wearing contact lenses for the first time. His eyes begin to tear. Mrs. Bachman thinks that he is crying over her misfortune. She consoles him, "I want you to know that you are the kindest, most sympathetic man I have ever met."
In "Intensive Care" an elderly woman is agitated after a seizure. The staff try unsuccessfully to calm her. Finally, her husband approaches and kisses her. She settles peacefully and they hold hands.
The doctor in "Continuing Medical Education" finally discovers metastatic breast cancer as the cause of a psychotherapist's neck pain, long after he and other physicians had told her again and again that the "driving mechanism" of her chronic pain was "unresolved anger and frustration." In a longer essay, "The Narrow Bridge," the author reflects on the meaning of healing, "Healing helps us find a place in this world for ourselves and for each other."
As a young woman, Fermina Daza kept a lengthy and passionate correspondence with Florentino Ariza, who was socially her inferior, but was desperately in love with her. They became engaged through their letters, exchanged through hiding places and telegrams in code.
But one day, when Fermina Daza comes close to Florentino Ariza in the market, she feels suddenly ill and tells him it was all a mistake. Instead, she marries Dr. Juvenal Urbino, a European-educated perfectionist, who falls in love with her on a medical visit. Their tumultuous but affectionate marriage lasts over fifty years, through a civil war, cholera outbreaks and the Doctor's brief affair with a patient. Juvenal Urbino distinguishes himself by instituting policies to combat cholera. He dies, falling from a tree as he attempts to catch his pet parrot.
Florentino Ariza comes to the wake. He is now about seventy and controls a wealthy shipping operation. After the other guests leave, he approaches Fermina Daza, saying, "I have waited for this opportunity for more than half a century, to repeat to you once again my vow of eternal fidelity and ever-lasting love."
She throws him out of the house, but continues to think of him. He becomes a regular visitor. Finally, they take a boat ride together, down the rivers that are being slowly drained and poisoned, listening for the cries of the manatees. They do not return, but prepare to sail on forever.
The story takes place in the men's cancer ward of a hospital in a city in Soviet Central Asia. The patients in Ward 13 all suffer from cancer, but differ in age, personality, nationality, and social class (as if such a thing could be possible in the Soviet "classless" society!). We are first introduced to Pavel Rusanov, a Communist Party functionary, who enters the hospital because of a rapidly-growing neck tumor.
We soon learn, however, that the book's central character is Oleg Kostoglotov, a young man who has recently been discharged from a penal camp and is now "eternally" exiled to this particular province. Only two weeks earlier, he was admitted to the ward in grave condition from an unspecified tumor, but he has responded rapidly to radiation therapy. Among the doctors are Zoya, a medical student; Vera Gangart, a young radiologist; and Lyudmila Dontsova, the chief of radiation therapy.
Rusanov and Kostoglotov respond to therapy and are eventually discharged; other patients remain in the ward, get worse, or are sent home to die. In the end Kostoglotov boards a train to the site of his "eternal" exile: "The long awaited happy life had come, it had come! But Oleg somehow did not recognize it."
This short narrative is told in the first person, the person of the quack. The tale opens with the narrator in the public hospital ward, suffering from what his doctors say is Addison's disease, composing the tale of his adventures which makes up the bulk of the work. The narrator tells us about his training as a physician and his first practice, which was sufficiently non-lucrative that he determines to alter his career direction.
He moves through a series of increasingly seamy scams in search of quick and easy money--including claiming to be a homeopathic physician, then an expert in vegetable remedies and "electromagnetic" treatment, falling through a multitude of suspect activities culminating in his setting up shop as a spiritualist. His shady career is cut short by his illness, from which he abruptly dies, thus ending the narrative.
This study explores the history of physician-patient relationships, especially as it relates to the ascendancy of science in medicine. The book begins by describing traditional physician-patient relationships in the 18th century. The focus, however, is on the "modern" doctor (beginning in the 1880's) and the "postmodern" doctor (beginning in the 1950's).
The author describes the transition from modern to postmodern doctor and a corresponding transition from modern to postmodern patient. A "sympathetic alliance" between physician and patient was essentially a development of the modern period (1880's - 1950's).
Dr. Hertzler leads the reader, topically and generally chronologically, through the nature of the practice of medicine in rural America from the 1880's through the 1930's. His early narratives are those of a child observing the ravages of epidemic diseases in the face of medical futility.
The remainder of the work, divided into subject headings, is devoted to anecdotes and observations on such things as horse and buggy home visits, kitchen surgery, the proprietary hospital and physician education. Having served not only as a rural practitioner, but as a professor of pathology at academic centers and a consulting surgeon, Hertzler draws on a wide experience over a period of time known for rapid advances in basic biological science which would, near the end of the narrator's life, open the way for technological medicine as we know it today.
This collection of vignettes follows the growth and development of one internist as he reflects on some of the critical experiences that shaped him as physician. The common thread of the work is the celebration of the relationship that can, and perhaps should, be built between the physician and his or her patient in the course of caring: this relationship is the sacred space of the title.
The author accomplishes his self-imposed task of describing this space by presenting situations in his practice life that illustrate the concept. The chronological structure of the collection enables the reader to study the maturation of the author as a self-reflective practitioner over the many decades of his professional life. Many of the stories are very funny; others are wrenching; all are gently told.