Showing 51 - 60 of 107 annotations tagged with the keyword "Impaired Physician"
In this sequel to his earlier seem-autobiographical novel, House of God, Shem (this time using both his pseudonym and his real name) describes the experience of a physician in the first year of a psychiatry residency in a prestigious private psychiatric hospital. In this first hand account it is assumed that the author is the resident, Dr. Roy Basch; he describes not only his experiences with a variety of patients but also with the other doctors and the staff members of the institution. It is not a happy place and in the telling of the story there is a biting irony and a sense of the absurd.
It is obvious from the first that Dr. Basch is very serious about becoming a psychiatrist but that he is also searching for meaning and connections. He finds that colleagues may often hurt you more than your patients. Another issue addressed is that of competing psychiatric theories, particularly the competition between pharmacologic treatment and psychoanalysis. Issues about drug treatment trials and the questionable way in which they are conducted also receive attention, as does the problem of insurance coverage for hospitalization.
The fact that psychiatrists often specialize in their own defects becomes a reality to Dr. Basch. There are not many exemplary people in this book--hopefully it exaggerates the real situation. There is, surprisingly, a sort of poignant positive ending.
This volume nicely supplements the few other anthologies of literature on medical themes currently available in that it covers a wider historical span. Selections from the Bible, Giovanni Boccaccio, William Shakespeare, Rabelais, as well as 18th-century writers including Pepys, Daniel Defoe, Malthus, Schiller, and Goldsmith provide an array of historical touchstones that offer windows onto medical and literary history and points of comparison for the larger selection of works from the 19th and 20th centuries.
The selections are mostly short--averaging around 10-12 pages. Each is introduced with lively, often witty, comments by Gordon, whose popular Doctor in the House series was adapted for stage and screen in England, and whose associations with the medical world include an editorial position on the British Medical Journal as well as a wife and two children who are physicians. Many of the selections focus on the figure of the physician viewed variously from the viewpoints of patients, other physicians, and him or herself.
Selections from novels by three Victorian women doctors as well as selections from several physicians’ diaries provide unusual additions to a useful collection of excerpts from well-known literature including works by Scott, John Keats, Jane Austen,George (Marian Evans) Eliot, George Bernard Shaw, Hardy, Aldous Huxley, Sir Arthur Conan Doyle, Sinclair Lewis, F. (Francis) Scott Fitzgerald, Waugh, Orwell, and more recent and popular fiction, up through Erich Segal.
This anthology frames a rich selection of fiction and nonfiction with astute and helpful introductions to issues in nineteenth-century medicine and the larger culture in which it participated. The fiction is comprised of Mikhail Bulgakov’s The Steel Windpipe in its entirety; Sir Arthur Conan Doyle’s story, "The Doctors of Hoyland" from Round the Red Lamp; and selections from George Eliot’s Middlemarch, Gustave Flaubert’s Madame Bovary, Sarah Orne Jewett’s A Country Doctor, Sinclair Lewis’s Arrowsmith, Thomas Mann’s Buddenbrooks, W. Somserset Maugham’s Of Human Bondage, George Moore’s Esther Waters, Robert Louis Stevenson’s Strange Case of Dr. Jekyll and Mr. Hyde, Eugène Sue’s Les Mystères de Paris, and Anthony Trollope’s Doctor Thorne [the full-length versions of many of the above have been annotated in this database]. The nonfiction consists of two versions of the Hippocratic Oath, two American Medical Association statements of ethics, and selections from Daniel W. Cathell’s The Physician Himself (1905).
David Moray is a wealthy physician in his fifties who lives in a Swiss villa, where he indulges his passion for collecting art. He is contemplating a relationship with the stylish yet impoverished Frida von Altishofer, but an idle comment overheard at a party brings an intoxicating memory from his youth. As an idealistic medical student, he once loved and planned to marry Mary Cameron, a simple, highland lass. But first, David had to take a long sea voyage as a ship doctor to recover from tuberculosis; there he met pouting but provocative Doris, and her hopeful parents.
The prospect of a fabulous income in the family’s drug business makes him abandon Mary and a medical practice. He marries Doris but within a short time she is permanently committed to an asylum. The family semi-apologizes for not having told him of her illness. David compensates for his miserable marriage with material possessions that are a proxy for self esteem, until Doris dies and sets him free.
The overhead remark sends him back to Scotland only to discover that his jilted Mary, who had married a minister, is now dead. Her daughter, Kathy, is a nurse and the very spit of her mother. He falls in love all over again. Kathy will not marry him unless he returns to practice and joins her and her uncle as missionaries in Africa. Full of good intentions, he agrees. But he does not tell Kathy about Mary, and he forces himself on her against her will.
When he assimilates the very real dangers of mission work, he simply fails to show up for the appointed rendezvous; he will marry Frida and keep his cherished possessions instead. Told bluntly by Frida of the marriage and of her mother’s past, Kathy drowns herself. David must identify her body. He then hangs himself from a Judas Tree.
This collection of sixteen Chekhov stories brings together in one volume many of Chekhov’s finest tales about doctors. The chronologically-arranged collection includes the famous novella, Ward 6, as well as such shorter classics as An Awkward Business and A Doctor’s Visit. In all sixteen stories, the doctor is a major figure, often at the center of a moral conflict.
Robert Coles , in his thoughtful forward, notes that Chekhov raises the "big questions" about "the meaning and purpose of life and the manner it ought to be conducted (and why)." Himself the editor of William Carlos Williams’s doctor stories, Coles recognizes and honors the comparison between Chekhov’s and Williams’s works and their dual careers as physician-writers. Jack Coulehan, in his introduction and comments, provides interesting biographical information on the great Russian writer as well as insightful interpretations of each story.
Dr. Forrest Janney, once a prominent surgeon, has given up his practice in the city and retired to his hometown in Alabama due to alcoholism. He runs the local pharmacy and keeps up his medical license, but doesn’t practice. His brother Gene begs Forrest to operate on their nephew, who is comatose from a gunshot wound in the head; he was sent home to die. Other doctors have refused to operate because the bullet is lodged close to a major artery at the base of his skull. Dr. Janney examines the young man. Although Janney declines to operate, citing his drunkenness and tremor, he encourages his family to keep trying to find a surgeon because he estimates a 25% chance of survival if the bullet is removed.
Shortly thereafter, a violent tornado plows through the town, leaving dozens of dead and wounded. Dr. Janney immediately pitches in with several other doctors to treat the wounded and makes supplies from his pharmacy available at no charge. The comatose nephew is also found in the wreckage, barely alive, and in order to give him at least a chance, Janney operates on him, despite being fortified by a heavy dose from his flask.
A few days later, the nephew presumably dies (not clear from the text). A little girl whom Dr. Janney has befriended is sent to the orphanage in Montgomery because her father died in the tornado. Shortly thereafter, Dr. Janney leaves town, after giving his house to his brother and his family. He is on his way to save the little girl from the orphanage.
In this first person narrative, Dr. Edward Haggard addresses his story to James, the son of his former lover Fanny Vaughn. Haggard, once a surgical registrar at a major hospital in London, has isolated himself in a coastal town, where he serves as a general practitioner. The "present" of Dr. Haggard’s story is the early stages of World War II, when James Vaughn, a Royal Air Force pilot, lies dying in Edward Haggard’s arms.
The story’s "past" has multiple dimensions. The outermost, framing story recounts the relationship between James and Edward that began several months before the war and a year or so following Fanny Vaughn’s death from kidney disease. James sought out the reclusive Dr. Haggard to discover the "truth" about Haggard’s relationship with his mother.
The inner story consists of Haggard’s description of his reckless and passionate love affair with Fanny, an ultimately hopeless liaison between a young registrar and the wife of the hospital’s senior pathologist. Their few brief months of happiness ended when Dr. Vaughn learned of the affair, and Fanny made the realistic choice to remain with her husband and adolescent son. In a confrontation between the two men, Vaughn knocked Haggard to the floor, causing a leg injury that resulted in chronic pain and permanent disability.
Haggard resigned from the hospital and withdrew to a solitary life, in which "Spike" (the name he gives to his deformed and painful leg) is his only companion. He must constantly "feed" Spike with intravenous morphine to quell the emotional, as well as physical, pain. The situation only worsens when Haggard learns of Fanny’s death from kidney failure.
The obsession worsens further still after James Vaughn shows up at his door. As Haggard treats the young pilot for a minor wound (he has become the local RAF surgeon), he notices that James has a feminized body habitus--gynecomastia, lack of body hair, broad hips, narrow shoulders, and pre-pubertal penis. He interprets this as "a pituitary disorder" and attempts to convince James that he needs treatment. James is repulsed by these advances, which eventually escalate.
This film traces the shared career and dissolution of Beverly and Elliot Mantle, male identical twins (both played, thanks to seamless special effects, by Jeremy Irons) who are gynecologists, running a successful fertility clinic in Toronto in the 1980’s. They share both work and personal lives; Elliot, the dominant twin, lectures at the hospital, accepts awards, plays the smooth professional--and seduces women. Beverly, the quiet one, sees patients, does research--and sometimes has affairs with women his brother passes on to him.
They usually draw the line at patients, not because of ethics, but because "it’s not safe." Their dealings with women have to be carefully compartmentalized, for the ambiguous intimacy of the gynecological doctor-patient relationship is difficult and dangerous for the twins, who form a psychologically unstable and deeply interdependent relationship on their own, likening themselves to the original Siamese twins, Eng and Chang, whose names they eventually take on, too.
Their symbiotic system is disrupted when a television actress, Claire Niveau (Genevieve Bujold), consults them about her infertility. She has a trifurcate uterus--the twins call her a "mutation"--and will never have children. Elliot, fascinated, seduces her, and then gives her to Beverly, who falls in love, with disastrous consequences. When Claire discovers that they’ve deceived her and temporarily leaves, Beverly becomes addicted to the amphetamines and sleeping pills that Claire habitually abuses.
The drugs impair his work, he begins to hurt patients, is hospitalized, and after a calamitous breakdown in the operating room (where Beverly attempts to use the monstrously beautiful surgical instruments he designed himself
"for operating on mutant women") both brothers keep their hospital privileges only on condition that they don’t use them. Elliot tries to rehabilitate Beverly, but realizes that the need to do so comes from their absolute interdependence--they might as well be physically joined. So Elliot begins taking drugs as well, and when Claire returns and Beverly goes back to her, Elliot breaks down completely.
The rest of the film traces Beverly’s failed attempt to become a separate individual. The instruments he invented are now, he says, "for separating Siamese twins," and, in a terrifying surgery scene, the drugged Beverly "operates" on his conscious though equally drugged brother, apparently disemboweling him. Next morning, Beverly leaves the apartment where his dead brother lies and calls the woman he loves, but he cannot talk to her. He goes back, his bid for independent identity a failure, and the film ends on a shot of the two, dead, in an embrace echoing the Renaissance anatomical illustrations of in utero twins which illuminate the film’s opening credits.
Dr. Gachet looks beyond the viewer with melancholy gaze. His eyes, drooped with sadness, appear to search resignedly for something in the distance; his skin tone is sallow. He rests his head on one hand, while the other hand rests precariously on the table beside him. Lines of color swim around and through the doctor--a technique distinctive to Van Gogh--all of which are directed almost uniformly towards the top left corner of the painting. Amidst this hubbub of color and energy, the Doctor rests impassively in what seems a commentary on his mental health.
Upon the red table rest two books and a vase of flowers. The books are titled Germinie Lacerteux (1864) and Manette Salomon (1867-68) and were written by two brothers who worked in close collaboration, Edmond and Jules de Goncourt. According to M. Therese Southgate, the books may thus represent the close relationship between Vincent van Gogh and his brother, Theo, which Southgate calls "symbiotic, and eventually tragic" (Theo became insane after Vincent's death and died six months later). (See page 207 of alternate source.) The vase contains flowers of foxglove, from which the heart medication digitalis is derived. The flowers, therefore, may represent the physician aspect of Dr. Gachet.
This collection contains all the stories in Arthur Conan Doyle's Round the Red Lamp, six additional medical tales (three of which are from the Sherlock Holmes oeuvre), and the published version of "The Romance of Medicine" (1910), an awards ceremony address to the medical students at St. Mary's Hospital Medical School.
Round the Red Lamp (see annotation in this database) received almost universally negative reviews when it was published in 1894. They deplored the fact that Conan Doyle wrote about such "nauseating" and "ghastly" topics. All but one of the stories deal with doctors, disease, or medical practice. (The exception is a gothic tale that has a medical student as its hero.)
For example, "Behind the Times" contrasts the behavior of old fashioned humanistic physicians with that of modern scientifically-oriented physicians; "The Doctors of Hoyland" conveys a very positive image of women physicians; "His First Operation" depicts a first-year medical student fainting in the operating room; and "A False Start" presents a humorous account of Conan Doyle's difficulties in starting his own medical practice.
The three Sherlock Holmes stories are "The Dying Detective" (1913), "The Creeping Man," (1923) and "The Blanched Soldier" (1926). "The Romance of Medicine" is an inspirational essay on professionalism and medical history, somewhat similar in tone to, and contemporaneous with, the essays of William Osler.