Showing 51 - 60 of 431 annotations tagged with the keyword "Professionalism"
Summary:In her reflections on the vocation of nursing Robinson explores many myths and archetypes that give shape and energy to the identity of the nurse as it has evolved in Western culture, including the stories of Hygeia, Baubo, Hermes, Hecate, Cassandra, and the Dionysian Maenad. The ancient stories of each of these figures and others articulate particular constraints, conventions, and conflicts involved in caregiving, especially in the ways women assume the role of caregiver. She explains at the outset that she deals particularly with women in nursing, though now many men are nurses, since traditionally it has been a profession deeply shaped by cultural notions of female roles. Another layer of this exploration is a chapter on the nurse in popular culture that considers ways in which the figure of the nurse has been both elevated and debased, made comic or tragic, sidelined or sexualized. The multidimensionality of the nursing vocation and, consequently, the challenge it poses to women who enter it, is strongly emphasized throughout the six chapters, which together depict the work of nursing as a soul journey. This journey challenges nurses in new ways to work within institutions that suppress important aspects of their power to do healing work at a level of intimacy generally not accessed by doctors.
At five years old, Willow O’Keefe has lived a life rich in love and exceptional learning; she reads beyond her years and has memorized a startling compendium of unusual facts. She has also sustained over 50 broken bones, two of them in utero. She has osteogenesis imperfecta, a congenital defect in the body’s production of type 1 collagen that leaves bones very brittle. People with the disease generally suffer many fractures and often other conditions—exceptionally small stature, hearing loss, and bowed limbs. Willow’s parents and older sister have organized their lives for five years around protecting her from damage and helping her heal from her many broken bones. Though Amelia, her older sister, loves Willow, her parents’, Charlotte and Sean’s, intense focus on Willow’s condition often leaves her jealous and disgruntled. Things go from bad to worse when their mother learns that a lawsuit for “wrongful birth” is legal in New Hampshire, and could bring them the money they need to cover Willow’s many medical expenses. Such a step, however, means losing a best friend, since the obstetrician who oversaw Charlotte’s pregnancy and Willow’s birth, and who ostensibly overlooked signs of the disease and failed to warn the parents, has been Charlotte’s best friend for years. A “wrongful birth” suit is based on the claim that medical information about a congenital defect was withheld that might have been grounds for a decision to abort the pregnancy. Though Charlotte insists this drastic step is the best thing they can do to insure a secure future for Willow, Sean finds it repugnant enough finally to leave home. It is clear that even a win will be a pyrrhic victory, and indeed, the outcome is ambiguous, costly, and life-changing for everyone concerned.
Summary:Emily Bauer, mother of two small children, psychotherapist and teacher, social, smart, athletic, and strong-willed, finds, after a curious series of falls and other accidents, that she has ALS, "Lou Gehrig's Disease," a disease that involves slow atrophy of all muscular control, leading to complete paralysis and then death. The disease is relentless, and treatments palliative at best.
Summary:Eric Calhoune is known to his classmates as "Moby" because of the extra weight he has carried since grade school. Though his mother is young and athletic, he has inherited the body type of the father he's never known. Now, in high school, the fat is turning to muscle under the discipline of hard swim team workouts. But that transformation has been slow in coming, since for some time Eric has taken on a private commitment to "stay fat for Sarah Byrnes." Sarah, whose name is a painful pun, was severely burned as a small child not, as we are given to believe early on, because of an accident, but because of a cruel and crazy father who stuck her face and hands into a woodstove in a moment of rage. She has lived with him and his threats for some time; that and her disfiguring scars have made her tough, smart, and self-protective. Eric and she became friends as social outcasts. Well-matched intellectually and in their subversive wit, they write an underground newspaper together. Sarah, however, lands suddenly in the hospital, speaking to no one, making eye contact with no one. Eric faithfully visits her and, per nurses' instructions, keeps up a running one-sided conversation as if she could hear him. As it turns out, she can. She is faking catatonia because the hospital is a safe place, and she has chosen this as an escape route from her father. Eric and a sympathetic coach/teacher go to great lengths to find Sarah's mother-who, it turns out, can't bring herself to be involved in her daughter's life because of her own overwhelming shame. Ultimately the father is apprehended, and Sarah, nearly eighteen, is taken into the coach's home and adopted for what remains of the childhood she bypassed long before. In the course of this main plot, other kids enter the story and in various ways come to terms with serious issues in their own lives, some of which are aired in a "Contemporary American Thought" course where no controversy is taboo.
Jerome Lowenstein is a nephrologist, author, and founder of the Bellevue Literary Press and the Humanistic Aspects of Medicine Education seminar program at the NYU School of Medicine. In this thoughtful and illuminating book of essays he explores the patient/physician relationship in a world where medicine has embraced technology and scientific advances in the laboratory at the risk of neglecting the humanistic underpinnings of the field.
Dr. Lowenstein graduated from medical school at NYU in the late 1950s and spent nearly his entire professional career at NYU Medical Center and Bellevue Hospital. When he was a resident, long before work hour limits were instituted, the house staff gathered in the cafeteria at midnight to dine on the days’ leftovers. This communal meal “provided a fine opportunity to communicate with colleagues directly, rather than by beeper and phone, about many of the days ‘medical leftovers,’ ” (1) sharing information as well as the frustrations and rewards of caring for patients. “The Midnight Meal” poses the challenge of retaining the core of relationships, both between patient and physician and among colleagues in the rapidly changing world of medicine today.
In the essay, “Can You Teach Compassion,” Dr. Lowenstein tells his readers about the student who responded to the question with “I don’t know if you can teach compassion, but you surely can teach the opposite.” (13) The student was referring to how students become “desensitized” during their clinical years to the suffering of their patients, sometimes to the point of using derogatory terms to describe them. Dr. Lowenstein argues that teaching attendings can and should encourage students to learn about their patients. He writes how he once interrupted an intern who began to present a case by stating: “This is the first hospital admission of this thirty-five year old IVDA.” Dr. Lowenstein asks: “Would our thinking or care be different if you began your history by telling us that this is a thirty-five-year-old Marine veteran who has been addicted to drugs since he served with valor, in Vietnam?” (17) Learning about the lives of their patients, Lowenstein emphasizes, does not detract from the clinical picture, but rather enhances it.
Summary:In this collection of "clinical tales," to use Oliver Sacks' term, Sue Hall, an experienced neonatologist who spent some years as a social worker before medical school, tells a remarkable range of stories about newborns in the NICU and their parents. As memoir, the stories record moments in a life full of other people's traumas, disappointments, anxieties, and hard-won triumphs where her job has been to hold steady, find a balance point between professionalism and empathy as young parents go through one of the hardest kinds of loss. Each story is told with clarity and grace, sketching the characters deftly and offering useful medical information along the way on the assumption that many who read the book will do so because they are facing similar challenges and decisions. Each story is followed by a two- to three-page "Note" giving more precise medical background and offering further resources for those who have particular interest in the kind of case it was.
Summary:It started with a faint. Javier Miranda, a generally healthy 69-year-old man living in Venezuela, attributes his episode of dizziness to the summer heat and humidity. His only child, Andres Miranda, is a physician whose intuition tells him something is seriously wrong with his father. The doctor obtains blood work and schedules a CT scan and MRI of the brain for Javier. The medical work-up reveals rapidly progressing lung cancer with metastases to the brain. Violating his credo of complete honesty with patients, Dr. Miranda lies to his father and reassures him instead. Dr. Miranda's mother died when he was just 10 years old. Now his father's remaining lifespan has dwindled to a couple of months. The doctor must find a way to break the bad news to his dad.
Summary:Parts of medical history read like detective novels. The discovery of the source of cholera by Dr. John Snow in London in 1854 is one of those episodes. The Ghost Map tells the story of Snow's pioneering work in what have now become standard epidemiological methods. Tracing a cholera outbreak to a local pump in a poor section of London involved many door-to-door visits working with people who weren't always cooperative, incurring the suspicion and/or ridicule of both them and the medical professionals with whom he worked. In the course of the story the author offers reflections on the organization of cities and on public hygiene. Snow, an out-of-the-box thinker, also helped develop surgical anesthesia.
In 1974, a student befriends Pärssinen, the gardener of his apartment complex in the town of Turku, Finland. Pärssinen invites him to drink and watch pornographic movies from his extensive collection. One night when both are full of alcohol, the gardener stops a girl on a bicycle, rapes and strangles her, and tosses the body in a lake. The drunken student is a baffled witness. The body resurfaces several months later, but the case is never solved. Her name was Pia.
More than thirty years later, in 2007, another girl, Sinikka, goes missing. Her bicycle is found with traces of her blood right beside the memorial shrine to Pia at the place of her murder. The retired cop, Ketola, is convinced that solving this new crime will also solve the old one.
At the same time, far away in Helsinki, Timo Korvensuo and his wife are entertaining friends. He is a successful real estate agent with a lovely, kind wife and two children, a boy and a girl. News of the missing girl greatly disturbs Timo and he leaves home headed to Turku telling his family it is for business. The reader realizes that Timo must be the unnamed student who witnessed the first murder.
In parallel with the police investigation, Timo’s abject wanderings in Turku seem to be centered on (re-)finding and perhaps outing the original killer. Police discover that Sinikka’s parents are consumed with guilt for the difficulties they have had with their adolescent daughter; they fear she has been snatched, perhaps killed, before they could patch things up. The father is a suspect.
Timo finds Pärssinen again and learns that he is unaware of the copycat crime. The police also also visit Pärssinen as a person of interest, but nothing comes of it. Timo goes to Pia’s mother, still living in the same home, to express his sorrow for her loss.
SPOILER ALERT! Primed by Ketola, Pia’s mother contacts the police. They raid Timo’s home in Helsinki and find child pornography on his computer. They know he cannot have committed the recent crime, but they are convinced that he killed Pia. As the noose tightens, Sinikka reappears alive and well from a hiding place in the forest. She staged the second crime as bait to lure the true killer in a plan she had cooked up for Ketola. Timo commits suicide and the police close both cases, but they are wrong.