Showing 51 - 60 of 108 annotations tagged with the keyword "Physical Examination"

Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

This haunting memoir by a South African surgeon who has witnessed tremendous suffering across the globe is best read as his story, and not a war chronicle as the subtitle would suggest, since large chunks of the book are not about war in the dressing station sense of the term. That said, however, the war that rages inside the author continues throughout the book and gives the reader glimpses of wisdom gained during Kaplan's remarkable journey of life amidst death. The book is culled from journals of writing and sketches that he kept throughout his travels.

Kaplan's first crisis occurs when he joins fellow medical students in an anti-apartheid demonstration in Cape Town and, following the lead of a more senior student, Stefan, tends to the wounded and frightened after riot police attacked the demonstrators. Kaplan then gets the call of not only medicine as service, but surgery as service, when, as a neophyte doctor, he saves the life of a youth shot in the liver by the police.

This feat should not be underestimated, though the author writes with humility. Indeed, in recounting later incidents in which patients die, the odds tremendously stacked against the patients surviving anyway (a woman with disseminated intravascular coagulopathy and multiple organ failure, or the Kurdish boy in a refugee camp with a great hemorrhaging, septic wound), the author's self-chastisement is a painful reminder of how the physician suffers with each loss.

After a beautifully written prologue which begins, "I am a surgeon, some of the time" (p. 1), the book proceeds chronologically, each chapter named for the location of the action. Kaplan leaves South Africa to avoid military service and the fate that befell Stefan, who becomes an opioid addict after euthanizing a torture victim in a horrible scene of police brutality and violence. Kaplan's post-graduate training in England and BTA (Been to America) research stint heighten his sense of cynicism about hierarchy in English society and capitalistic forces in American medical research.

Ever the outsider, Kaplan first returns to Africa (treating victims of poverty, deprivation and violence), then sets off to war zones in Kurdistan, Mozambique, Burma (Myanmar), and Eritrea. In between, he works not only as a surgeon, but also a documentary filmmaker and a cruise ship and flight doctor. He avoids the more established medical humanitarian relief efforts, such as Médecins Sans Frontières, and instead prefers to work where no other ex-pat physician will go--enemy territory, front lines, and poorly equipped dressing stations.

Along the way he decides the number of people he has helped as a surgeon, particularly in Kurdistan, has been small compared to the potential to intervene in broader public health measures (he meets a Swiss water treatment engineer) and occupational health exposés to help abused victims (e.g., of mercury poisoning in South Africa and Brazil). The book ends with Kaplan studying to become an expert in occupational medicine, though, incongruously, in the heart of London's financial district where he treats stress-related illness.

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Ripe

Jacobstein, Roy

Last Updated: Oct-12-2006
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

This is the first full-length collection by pediatrician and international health physician Roy Jacobstein. These 40 poems engage a wide range of topics, settings, and tones, but all demonstrate the same fine craftsmanship and strong voice.

Among the most engaging of Jacobstein’s poems are those dealing with memories of childhood and adolescence. Consider, for example: “Mr. Gardner in 10th grade told us there was no purpose / to mitochondria, only function.” (“Atomic Numbers,” p. 5). Or, “What transgression made fat Mr. Handler / drop his towel, his gloves, everything… to chase you from one end / of Fullerton to the other?” (“The Lesson,” p. 30) The poet displays a delightful sense of humor in pieces like “Bypass” (p. 36) and “Squid’s Sex Life Revealed in USA Today” (p. 59). Poems with explicit medical themes include “Pre-Med” (p. 6), “Admissions” (p. 8), and “What It Was” (p.11).

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Medicine: The Art of Healing

Nuland, Sherwin

Last Updated: Sep-01-2006
Annotated by:
Shafer, Audrey

Primary Category: Visual Arts / Painting/Drawing

Genre: Art with Commentary

Summary:

The author selected 48 works of art, famous and obscure, which are presented in chronological order as full-page color plates. On the facing page of each piece is a brief essay which includes information such as artist, date and current location of the work. The essays, as well as the introduction by the author, are insightful, well-written, and demonstrate the author’s vast knowledge as a medical historian. Selections include the "Oath of Hippocrates", Studies of the Fetus by da Vinci, The Anatomy Lesson of Nicolaes Tulp by Rembrandt, The Dwarf Sebastian de Morra by Velazquez, "Muscle-Man from Vesalius" by van Calcar, and First Operation Under Ether by Hinckley (see art annotation in this database).

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Summary:

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).

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Medical Ethics

Karnezis, Panos

Last Updated: Aug-31-2006
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Dr. Panteleon has practiced medicine for more than forty years in a town where his patients rarely became ill. One day, a girl arrives at his office requesting a gynecological examination. The doctor performs a silent and mechanical pelvic exam. The girl’s stepfather wants the physician to certify that the young woman is a virgin and able to have children. The stepfather has given her an ultimatum. She must marry either the town butcher or Dr. Panteleon. She hates the butcher and the doctor will not marry her.

The girl asks for help. The stepfather suffers from chronic constipation and hemorrhoids. Although critical of Dr. Panteleon’s treatment of his problem, the stepfather nevertheless requests additional medicated suppositories. Before embarking on a house call to meet with the lazy man and discuss the young woman’s plight, Dr. Panteleon prepares six special suppositories laced with a poison that will make constipation the least of the stepfather’s problems.

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Episode of Hands

Crane, Hart

Last Updated: Aug-17-2006
Annotated by:
Terry, James

Primary Category: Literature / Poetry

Genre: Poem

Summary:

The gashed hand of a factory worker is bandaged by the factory owner’s son. The worker is at first embarrassed, then compliant. As his fingers work, the owner’s son begins to notice the details of the other hand and to conjure images--"wings of butterflies" and "the marks of wild ponies’ play"--in the worker’s rough hand. Somehow this establishes a brief bond that transcends the class barrier between the two in an act of healing.

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Annotated by:
Nixon, Lois LaCivita

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Frears presents a stark portrayal of London’s underbelly, a place where everything is for sale--at a price. It is a world in which most people tend to ignore or overlook: prostitution, illegal immigrants struggling to survive, illegal activities, humiliating circumstances, and most centrally, black market organ transplantation. "We are the people you don’t see." Information age technologies mix with greed and desperation to depict an engrossing and sordid narrative about real-life events occurring in places beyond the ordinary purview. This modern day thriller brings audiences to the edge of their seats as they witness harrowing and very believable accounts of marginalized members of society deprived of basic human dignities.

The story is complex but two characters dominate, a doctor from Nigeria (Chiwetel Ejiofor) now reduced by harsh circumstances to several menial jobs including taxi driving and hotel clerking, and an illegal chambermaid from Turkey (Audrey Tautou) whom he befriends and assists. She lives in constant danger of humiliation, exposure, deportation. Their paths cross in a hotel where both work, where "johns" are served by prostitutes, and where illegal and sloppy surgical procedures are employed to harvest kidneys from desperate donors.

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Death by Aesthetics

Van Duyn, Mona

Last Updated: Aug-16-2006
Annotated by:
Aull, Felice

Primary Category: Literature / Poetry

Genre: Poem

Summary:

A witty and wildly imaginative evocation of a female patient’s encounter with a male physician. The poem is full of the counterplay of eroticism and sterile technology, of the body as love object and object of diagnosis, of the doctor’s cool clinicality and the patient’s desperate neediness. To her, the doctor is an "abstracted lover" for whom she willingly lies down "while he unfolds / her disease . . . ." Orgasmically, "he warms / to his consummation" which is for him "a most enjoyable diagnosis." He is finished with her but she feels cheated--he hasn’t grasped her essence. "Don’t leave me! Learn me!" " . . . taste my living texture. / Sweat to hunt me with love, and burn with me."

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Dead Ringers

Wilson, Jonathan

Last Updated: Aug-16-2006
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

When 47-year-old Henry Newman experiences testicular pain, he gets little pity from his wife, Arlene. His personal physician, Dr. Vikrami (a woman who has only reluctantly examined Henry’s "private parts" in the past) schedules him for an ultrasound study of the testicles rather than examining him first. A young nurse performs the test and a female radiologist apprises Henry of the findings-- epididymitis.

A urologist confirms the diagnosis, but Henry is more interested in learning that the doctor has a twin brother who is also a urologist. Henry goes to see his 80-year-old mother who resides in a convalescent home. She pesters him about checking on the condition of his brother’s grave. His brother, Aubrey, died as an infant, and Henry was born two years later.

Henry visits the cemetery and finds the small tombstone marking Aubrey’s grave covered by weeds and bird excrement. He tidies it up. When Henry returns to the convalescent home, his mother’s bed is empty. He fears she has died but then spots her exiting a bathroom. Henry tells her that he has finally spruced up Aubrey’s grave, but she seems oblivious to his announcement and just babbles on.

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The Abortion

Walker, Alice

Last Updated: Jun-15-2006
Annotated by:
Nixon, Lois LaCivita

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The story does concern an abortion, but, more so, the failure of the protagonist’s husband to participate in essential discussions relating to their marriage. Imani, a well-educated black woman, and her husband, Clarence, have a two-year old child and a seemingly good life. The marriage, however, is on uneasy ground because Clarence’s focus has shifted from family to job. Busy as a key advisor to the mayor, he has not thought about this, but Imani, now pregnant, has had time to reach this disturbing conclusion. She decides that unless Clarence will fight to save this child, she will abort the pregnancy. When he fulfills her expectations, quickly acquiescing to her termination plans, Imani recognizes that the partnership is over.

For Imani, abortion is no small matter nor is it new. While still in college, she had undergone a brutal experience with severe hemorrhaging. This time it is an "assembly line" event with no complications, but, again, she is alone. Clarence, oblivious to her smoldering rage about his complacency, subordinates her needs to those associated with his job.

The abortion concretizes the distance between them: "She had known the moment she left the marriage, the exact second. But apparently that moment had left no perceptable mark." Twice Imani had been scarred by abortion, and Clarence, oblivious to these marks, remained in uncomprehending disbelief as the marriage deteriorated and, then, dissolved.

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