Showing 51 - 60 of 176 annotations tagged with the keyword "Women in Medicine"

Night Nurse

Macy, Dora

Last Updated: Feb-25-2008
Annotated by:
Garden, Rebecca

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Nurse Lora Hart is working on a private case with two young children who are suffering from malnutrition. They live in a wealthy and chaotic household. Their father is dead, and their mother, who is an alcoholic, and her fortune have fallen into the clutches of her scheming brother-in-law and her thuggish chauffeur, both of whom have been her lovers, among others. The physician caring for the children has been bribed by the children’s uncle, who wants the children to die so that he can marry his sister-in-law and claim her fortune. Nurse Hart secretly defies the physician’s orders and nurses the children back to health. She weathers an attempted rape and a sock on the jaw in the course of her duty at the troubled home. She makes use of her bootlegger boyfriend (this is a Prohibition-era novel) to set up the chauffeur who hit her, and when she learns that the chauffeur has raped her employer’s older daughter, she promises to testify against him in court, even though that results in her being fired from the case and blackballed from hospital work.

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The Fruit of the Tree

Wharton, Edith

Last Updated: Oct-29-2007
Annotated by:
Garden, Rebecca

Primary Category: Literature / Fiction

Genre: Novel

Summary:

The novel opens with a young surgical nurse, Justine Brent, nursing a mill worker whose arm has been mangled by a carding machine. She soon meets John Amherst, the mill’s assistant manager who works passionately to reform the dangerous conditions at the mill and to improve the living conditions of the workers. Amherst recognizes Justine’s intelligence and sympathy, but he quickly forgets about her when he meets and falls in love with the new mill owner, Bessy Langhope.

The narrative skips ahead three years. John Amherst has learned that his now-wife Bessy has no real interest in his plan to reform the mill, although she initially appeared to be moved by the workers’ misery. In fact, her insistence on luxury, which is funded by the profit from the mills, thwarts his desire to use her controlling interest to make significant changes. The couple encounters Justine, who knew Bessy in school. When the somewhat sickly Bessy invites her to be a private nurse to herself and her stepdaughter, Justine, who is exhausted from “difficult cases,” accepts. Justine attempts to shore up John and Bessy’s increasingly troubled marriage without success. When John is abroad, Bessy has an accident while riding her horse. Paralyzed, in constant pain, and slowly dying, Bessy is attended by a physician who advances his career with the technological feat of keeping Bessy alive, ostensibly until her husband and her father arrive to say their goodbyes. When Bessy begs Justine to let her die, Justine secretly gives her a fatal dose of morphine, an act that the physician suspects.

The narrative skips ahead again to over a year later when Amherst, who has inherited the mills from Bessy, invites her family to celebrate the opening of an emergency hospital he has built in the mill town. Justine, who had stayed on after Bessy’s death as her stepdaughter’s nurse, and Amherst become reacquainted. Their shared social and intellectual interests develop into love, and they marry. The physician who had cared for Bessy and who had, earlier, asked Justine to marry him, had developed an addiction, one that had begun while he was treating Bessy. Beginning to sink into financial ruin, he blackmails Justine. Eventually, Amherst finds out that Justine killed Bessie with morphine and, horrified, rejects her.

Justine confesses her act to Bessy’s father and negotiates a deal: She will remove herself from their lives if he allows Amherst to continue his work at the mills. Bessy’s father accepts the deal, and Justine disappears for many months until Bessy’s daughter becomes ill and begs to be reunited with Justine. A family friend explains to Amherst Justine’s arrangement to protect him and convinces him that she has suffered suitable penance. Justine is reunited with Amherst when he celebrates the opening of a gymnasium for the mill workers, a project he credits Bessy with having designed. Justine, who knows that Bessy had in fact designed the gymnasium for her private estate, a project that would have drained the funds for improving the mills, keeps silent and subverts her knowledge to her husband’s perception of the facts.

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Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Collection (Essays)

Summary:

Part of a series, "Letters to a Young . . . [fill in the career]," this collection of essays by pediatrician-author Perri Klass is addressed to her son Orlando during the recent period when he was applying to medical school. The essays follow a chronological sequence, beginning with the decision to apply to medical school, the first two years of medical school, learning how to examine and talk to patients, residency training, physicians as patients, making mistakes, grappling with the most fundamental human issues in medicine, and the mingling of professional work and life.

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Sutton's Law

Orient, Jane; Wright, Linda

Last Updated: Jun-28-2007
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Intern, Maggie Altman, begins her postgraduate training in a large Texas hospital where a new computerized system has been implemented to improve service. She pours heart and soul into her work, but her admissions always seem to be the sickest patients who keep dying, sometimes inexplicably. Maggie becomes suspicious of her colleagues and of Dr. Milton Silber, an irrascible, retired clinician with no fondness for the new technology. Silber also happens to be a financial genius. Overhearing conversations and finding puzzling papers, Maggie imagines a scam, in which her supervisors may be eliminating dying patients to reduce costs, improve statistics, and siphon funds to their own pockets.

The bad outcomes for Maggie's patients are noticed and criticized, and she is pressured to drop out, switch hospitals, or go back into research. She senses that the perpetrators are aware of her suspicions and send her the worst patients in an effort to eliminate her. She trusts no one. These worries are compounded by her own illness and her accidental discovery in the morgue of a traffic in unclaimed bodies. With the help of excellent clinical skills, true friends, Dr. Silber, and a new love interest who is a budding financial genius, she survives physical and emotional violence and solves the mystery of patient homicides, poisonings, and fraud.

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Summary:

In this collection, twenty-two medical students and young physicians across the United States eloquently recount the process of medical education for those who do not believe they fit standard measures of student demographics. The editors, Takakuwa, an emergency medicine resident physician; Rubashkin, a medical student; and Herzig, who holds a doctorate in health psychology, group the essays into three sections: Life and Family Histories, Shifting Identities, and Confronted.

Each section is prefaced by an essay explicating the essay selection process, the history of medical school admissions policies and requirements, the basic progression of medical education and the reasons for this collection, such as "putting a human face" (p. xx) on the changing characteristics of admitted medical students: "With their diversity and through their self-reflections, we hope that these students will bring new gifts and insights to the practice of medicine and that they might one day play an important role in transforming American medical education into a fairer and more responsive system." (p. 141)

Additionally, a foreword by former Surgeon General Joycelyn Elders outlines her experience as a black woman entering medical school in 1956, including eating in the segregated cafeteria. The book concludes with recommendations for further reading and improvements to the medical education process as well as with brief biographies of the contributors and editors.

The range of essays is impressive: diversity itself is given a new meaning by the variety of narrative voices in this volume. Contributors include people from impoverished backgrounds, both immigrant (Vietnamese, Mexican) and not. One student, marginalized by his academic difficulties, began a homeless existence during his first clinical year. Others were made to feel different because of being African or Native American.

In two essays, mothers defy labels placed on them (pregnant black teen; lesbian) and describe the trials and triumphs of their situations. Students write of being subjected to ridicule, ignorance and prejudice due to their gender, interest in complementary medicine, political and advocacy views, or religious beliefs. Due to pressures to conform, even students from what might be considered more mainstream in American culture (e.g., growing up in a small town, or being Christian) can experience the effects of being "different" when in medical school.

A number of essays communicate the difficulties of illness, disability and bodily differences. Issues include recovered alcoholism (rather tellingly, this is the only essay that is anonymous), obsessive compulsive disorder, sickle cell anemia, Tourette Disorder, attention deficit hyperactivity disorder, chronic pain, and obesity. The authors balance their narratives of hardship with insights into how their struggles improve their opportunities for empathy, perspective and fulfillment as physicians.

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Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

A group of eight women gather for a joint consultation with Dr. Kailey Madrona who is a devotée and colleague of the research endocrinologist, Dr. Jerilynn Prior, a professor at University of British Columbia in Vancouver. Madrona explains that she has arranged for the unorthodox group encounter because she will be leaving practice to pursue graduate studies in medical history.

Dr. Madrona leads an open-ended discussion on the physiological changes associated with perimenopause. Following the controversial research of Prior, she emphasizes that the symptoms are owing to the unbalanced rise in estrogen levels during perimenopause—a period leading up to the cessation of menstruation and continuing for twelve months after the last flow.

Some women patients are skeptical, because they have been placed on estrogen ‘replacement” medication, or they have read that their symptoms are owing to the waning of estrogen. The doctor describes the results of various trials about supplmentary estrogen, including the 2002 Journal of the American Medical Association report. She invites them to keep detailed diaries of their cycles and symptoms.

One by one the women return for private consultation, physical examination, discussion and another follow up visit. Although they have reached roughly the same physiological moment in life, they are a diverse group with different symptoms and needs. Darlene, an angry nurse, is suspicious and non-compliant. Beverley, an Asian immigrant is still hoping to become pregnant. A lesbian wishes to control her moods and hot flashes. A very hard-working waitress needs to understand her strange lack of energy. A wiry, lean athelete wants to improve her performance and is irritated by the inexplicable alterations in her abilities. Others are plagued by sweats, nausea, or migraines. They all are confused about sex.

Dr. Madrona listens to them carefully, examines them with special attention to their breasts, not their genitalia, and recommends treatment with progesterone for everyone. She also urges weight gain for most and readily volunteers personal information about her own perimenopause. All but the nurse eventually comply and are relieved of their symptoms. At the end of a year they meet for a pot-luck dinner to celebrate their recovered health and thank their doctor. Beverley is pregrant.

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The Vanishing Line

Grainger-Monsen, Maren

Last Updated: May-19-2007
Annotated by:
Shafer, Audrey

Primary Category: Performing Arts / Film, TV, Video

Genre: Video

Summary:

Maren Grainger-Monsen, a filmmaker and emergency medicine physician, chronicles her personal journey towards understanding death and dying as she explores the stories of those near death. The film uses a metaphor of the thread of life, and the three Greek Fates who control life (spinning, measuring and cutting this thread), to interweave Monsen's journey with the lives--and deaths--she encounters.

The film begins with her recollection of two experiences during her emergency medicine training: the first time she is paged to pronounce someone dead and a "crisis point"--resuscitating a patient, brought to the emergency room, who had specifically requested no resuscitation. The remainder of the film focuses on Jim Brigham, a social worker for a hospice program, whom Monsen joins for his home hospice visits and who relates the touching and memorable story of his wife's life and death.

Some of the patients Jim visits are Tex, a man dying of heart failure who had experienced a difficult, scary night; Sean, who has Lou Gehrig's disease and who needs help with paperwork and family concerns; and Anna Marie, who has lymphoma and is taken via ambulance to the hospital for comfort measures. Monsen notes how comfortable Jim is discussing death issues and how compassionate and caring he is with a recent widow in the midst of her "grief work." By contrast, Monsen admits to feelings of helplessness, vulnerability, even terror. She wishes her medical education had not been so devoid of teaching regarding death and dying.

Monsen comments on the wavering line between life and death, and whether the "medical machine" prolongs life or death. She visits a young boy left with severe brain damage following a near-drowning incident and "successful" resuscitation 5 years previously. The boy requires constant care, but his father notes that his son is "doing pretty good."

By the end of the film, Monsen has learned "how to sit with someone . . . while death walks into the room." Death no longer equates with failure. She concludes with her overvoice, "I wonder what it will be like to be a doctor who doesn't see death as the enemy."

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Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: History

Summary:

In this account of early practitioners and advocates of 'inoculation,' or the use of tiny amounts of smallpox contagion to induce a mild case of smallpox and immunity, author Carrell weaves prodigious historical research with fictionalized dialogue to create a tale of two prominent figures: Lady Mary Wortley Montagu of London and Dr. Zabdiel Boylston of Boston. Both Lady Mary and Boylston suffered scarring from smallpox, and, by living in the early 18th century, both witnessed the devastation of epidemics in terms of public health and private loss.

Both were also aware of the use of inoculation to prevent severe disease in Turkey (Lady Mary visited with her ambassador husband) and in Africa (on the advice of Cotton Mather, Boylston interviewed Africans, slave and freemen, living in Boston). Both faced formidable challenges and risked personal security to promote the use of this technique. Both proved their belief in the technique by the inoculation of their own children. And both, perhaps, met. At the behest of the Royal Society, Boylston traveled to London, witnessed numerous inoculations, and presented his Boston experience to the Society.

The book also chronicles the natural course of the disease, its various symptoms, forms and popular treatments, and the political impact of smallpox on the royal families of Europe and business interests in Boston. The medical research of various doctors is detailed. In particular, selected Newgate prisoners were offered pardon in return for participation in an experiment conducted by Mr. Maitland, who also inoculated Lady Mary's children. These experiments were used to test the safety and efficacy of inoculation prior to royal inoculation.

Ultimately, detractors of inoculation ceased their vitriolic attacks, as the risks of inoculation were proven to be far lower than exposure without such protection. The success of inoculation paved the way for Edward Jenner, often called 'the father of immunology,' to successfully use cowpox to induce smallpox immunity later in the 18th century.

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Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Dr. Pauline Chen is a transplant surgeon and hence highly trained in the surgical care of desperately ill patients. She found, however, that although she had intensive and first rate training, time and again the message she received from her mentors and peers encouraged a distance from frank discussions about dying with patients who were clearly dying. Dr. Chen successfully suppressed her urges to reflect on the meaning of illness and death. Years into her training, she finally witnessed an attending surgeon stay with a patient and the patient's wife until the patient passed away. The widow sent a thank you note to Dr. Chen for allowing a "dignified and peaceful death." (p. 101) Chen notes that observing her attending stand with the patient during death changed her profoundly: "...from that moment on, I would believe that I could do something more than cure. This narrative, then, is my acknowledgment to him." (p. 101)

Final Exam chronicles Chen's journey from medical student to attending surgeon and examines her experiences with death and serious illness - of patients, family members, friends. The memoir contains three parts: Principles, Practice, and Reappraisal - each with three chapters. The book is chronologically arranged, beginning with anatomy dissection at the start of medical school and ending with Chen as an attending arranging for hospice, thus honoring a patient's desire to die at home rather than in hospital. Chen skillfully weaves her stories around commentary on the social, cultural and philosophical issues surrounding death and the medical response to death. An introduction and epilogue bookend the text and 46 pages of extensive notes and bibliography complete the book.

Although Chen claims to have slowly and painfully awakened to the fact that patient needs extend well beyond good technical care, in fact one sees Chen emerge as a caring physician even from her initial patient contacts in medical school. Chen speaks more to her role as an Asian-American than to being a woman in a male-dominated field, but she clearly has what it takes to succeed in this extremely competitive field, including a good dose of compulsiveness and an incredible work ethic.

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Vegetative States

Caspers, Nona

Last Updated: Mar-05-2007
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

An already depressed second year medical student, Deborah, finds herself even more confused about the meaning of life after her aunt sustains a head injury and is in critical condition. Auntie Jenny’s convertible car collides with a utility pole and the impact ejects the woman (who was not wearing a seatbelt) onto the concrete road where she smacks her head. Five days later, Jenny remains in a vegetative state and connected to a ventilator. Deborah’s mother and Auntie Sal keep vigil over their unresponsive younger sister.

Deborah has been slacking – missing classes, sleeping a lot, and uninterested in most activities she formerly enjoyed. Previously she has suffered from insomnia and has fifteen barbiturate sleeping pills remaining. She questions the medical librarian as to how the drug works and the physiologic effects of an overdose. In the seventh grade, Deborah was hospitalized and out of school for one month with unexplained abdominal pain. In retrospect, her mother now admits that Deborah was likely suffering from depression as a child but no diagnosis was made and no treatment provided.

Jenny’s medical status remains unchanged. Deborah’s mother gives her an ultimatum: “You’ve got to make up your mind. The living or the dead” [p 119]. Deborah envies Jenny. No more worries about finding answers to important questions. Survival itself seems to be out of her control. Jenny’s fate rests in the hands of her close relatives who confer with the doctor about whether to continue artificial life support or “pull the plug.”

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